Successful Salvage Treatment of Resistant Acute Antibody-Mediated Kidney Transplant Rejection with Eculizumab.
Antibody-mediated rejection (ABMR) jeopardises short- and long-term transplant survival and remains a challenge in the field of organ transplantation. We report the first use of the anticomplement agent eculizumab in Oman in the treatment of a 61-year-old female patient with ABMR following a living unrelated kidney transplant. The patient was admitted to the Sultan Qaboos University Hospital in Muscat, Oman, in 2013 on the eighth day post-transplantation with serum creatinine (Cr) levels of 400 µmol/L which continued to rise, necessitating haemodialysis. A biopsy indicated ABMR with acute cellular rejection. No improvement was observed following standard ABMR treatment and she continued to require dialysis. Five doses of eculizumab were administered over six weeks with a subsequent dramatic improvement in renal function. The patient became dialysis-free with serum Cr levels of 119 µmol/L within four months. This case report indicates that eculizumab is a promising agent in the treatment of ABMR.
Department of Medicine, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman.
Saif A
SA
Khan
Department of Medicine, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman.
Dawood
D
Al-Riyami
Department of Medicine, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman.
Yasser W
YW
Al-Mula Abed
Department of Medicine, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman.
Saja
S
Mohammed
Department of Pathology, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman.
Marwa
M
Al-Riyami
Department of Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman.
Nabil M
NM
Al-Lawati
Case Report; Complement Activation; Eculizumab; Kidney Transplantation; Oman; Transplantation Rejection