title: Eculizumab for the Treatment of Severe Antibody-Mediated Rejection: A Case Report and Review of the Literature.
abstract: In renal transplantation, treatment options for antibody-mediated rejection are limited. Here, we report a case of severe AMR treated with eculizumab. A 50-year-old woman known for end stage kidney disease secondary to IgA nephropathy received a kidney transplant from a 50-year-old deceased donor. At 5 months after transplantation, she presented with acute graft dysfunction and biopsy showed a severe antibody-mediated rejection associated with thrombotic microangiopathy. Despite an aggressive conventional immunosuppressive regimen, signs of rejection persisted and the patient was treated with 3 doses of eculizumab. Following the therapy, markers of TMA improved and graft function stabilized. However, ongoing signs of rejection remained in the repeated biopsy. In kidney transplantation, eculizumab is an expensive treatment and its role in the treatment of antibody-mediated rejection remains to be determined.
authors.affiliation: Department of Nephrology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada H1T 2M4.
authors.forename: Duy
authors.identifier: 0000-0001-6783-9976
authors.initials: D
authors.lastname: Tran
authors.affiliation: Department of Nephrology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada H1T 2M4.
authors.forename: Anne
authors.initials: A
authors.lastname: Boucher
authors.affiliation: Department of Nephrology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada H1T 2M4.
authors.forename: Suzon
authors.initials: S
authors.lastname: Collette
authors.affiliation: Department of Nephrology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada H1T 2M4.
authors.forename: Alexis
authors.identifier: 0000-0002-0000-4066
authors.initials: A
authors.lastname: Payette
authors.affiliation: Department of Pathology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada H1T 2M4.
authors.forename: Virginie
authors.identifier: 0000-0001-7036-8423
authors.initials: V
authors.lastname: Royal
authors.affiliation: Department of Nephrology, Maisonneuve-Rosemont Hospital, Montreal, QC, Canada H1T 2M4.
authors.forename: Lynne
authors.initials: L
authors.lastname: Senécal