The Use of Antibody to Complement Protein C5 for Salvage Treatment of Severe Antibody-Mediated Rejection
The Use of Antibody to Complement Protein C5 for Salvage Treatment of Severe Antibody-Mediated Rejection
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DOI：
10.1111/j.1600-6143.2008.02451.x
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发表时间：
2009-01-01
影响因子：
8.8
通讯作者：
Montgomery, R. A.
中科院分区：
文献类型：
--
作者：
Locke, J. E.;Magro, C. M.;Montgomery, R. A.
脱敏患者发生急性抗体介导的排斥反应（AMR）的风险很高。在大多数情况下，排斥反应是轻微的，并响应于短期的血浆置换（PP）/低剂量IVIg治疗。然而，一部分患者发生了与突发性少尿相关的重度AMR。我们先前描述了紧急脾切除术在抢救这类严重AMR患者的同种异体移植物中的实用性。然而，并非所有患者都适合脾切除术。在这里，我们提出了一个单一的情况下，艾库组单抗，补体蛋白C5抗体，抑制膜攻击复合物（MAC）的形成，与PP/IVIg相结合，以挽救肾脏经历严重AMR。我们显示在施用依库珠单抗后肾脏中C5 b-C9（MAC）复合物沉积显著减少。
Desensitized patients are at high risk of developing acute antibody-mediated rejection (AMR). In most cases, the rejection episodes are mild and respond to a short course of plasmapheresis (PP) / low-dose IVIg treatment. However, a subset of patients experience severe AMR associated with sudden onset oliguria. We previously described the utility of emergent splenectomy in rescuing allografts in patients with this type of severe AMR. However, not all patients are good candidates for splenectomy. Here we present a single case in which eculizumab, a complement protein C5 antibody that inhibits the formation of the membrane attack complex (MAC), was used combined with PP/IVIg to salvage a kidney undergoing severe AMR. We show a marked decrease in C5b-C9 (MAC) complex deposition in the kidney after the administration of eculizumab.