Prompt reversal of a severe complement activation by eculizumab in a patient undergoing intentional ABO-incompatible pancreas and kidney transplantation
2011 (English)In: Transpl Int, Vol. 24, no 8, e61-6 p.Article in journal (Refereed) Published
We describe the presumably first intentional ABO-incompatible deceased-donor kidney and pancreas transplantation with a severe antibody-mediated rejection during a rebound of isoagglutinins. Rejection was successfully treated with eculizumab, which inhibits the terminal pathway of complement. Complement analysis (C3, C3d,g, and a modified assay of classical complement-related hemolytic function) documented complement activation and confirmed that eculizumab completely blocked complement function. At 6 months, the patient had normal kidney and pancreas function, and histological evaluations revealed no evidence of sustained graft damage. This successful transplantation suggests that ABO barriers can safely be overcome without extensive preconditioning, when the complement inhibitor eculizumab is included.
Place, publisher, year, edition, pages
2011. Vol. 24, no 8, e61-6 p.
ABO Blood-Group System/*immunology, Adult, Antibodies, Monoclonal, Humanized/*pharmacology, Blood Group Incompatibility/*immunology, Complement Activation, Complement System Proteins, Diabetes Mellitus/therapy, Enzyme-Linked Immunosorbent Assay/methods, Humans, Immunophenotyping/methods, Immunosuppressive Agents/therapeutic use, Kidney Transplantation/*methods, Male, Pancreas Transplantation/*methods, Renal Insufficiency/complications/*therapy
IdentifiersURN: urn:nbn:se:umu:diva-110899ISBN: 1432-2277 (Electronic) 0934-0874 (Linking)OAI: oai:DiVA.org:umu-110899DiVA: diva2:865893
Biglarnia, Ali-Reza Nilsson, Bo Nilsson, Thomas von Zur-Muhlen, Bengt Wagner, Michael Berne, Christian Wanders, Alkwin Magnusson, Anders Tufveson, Gunnar eng Case Reports England 2011/06/24 06:00 Transpl Int. 2011 Aug;24(8):e61-6. doi: 10.1111/j.1432-2277.2011.01290.x. Epub 2011 Jun 22.2015-10-292015-10-292015-10-29