Prompt reversal of a severe complement activation by eculizumab in a patient undergoing intentional ABO-incompatible pancreas and kidney transplantation
Prompt reversal of a severe complement activation by eculizumab in a patient undergoing intentional ABO-incompatible pancreas and kidney transplantation
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DOI：
10.1111/j.1432-2277.2011.01290.x
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发表时间：
2011-08-01
影响因子：
3.1
通讯作者：
Tufveson, Gunnar
中科院分区：
文献类型：
--
作者：
Biglarnia, Ali-Reza;Nilsson, Bo;Tufveson, Gunnar
我们描述了可能是第一个有意进行的 ABO 血型不相容的已故供体肾脏和胰腺移植，在同种凝集素反弹期间出现了严重的抗体介导的排斥反应。依库丽单抗成功治疗了排斥反应，它抑制了补体的末端途径。补体分析（C3、C3d、g 和经典补体相关溶血功能的改良测定）记录了补体激活，并证实依库丽单抗完全阻断补体功能。 6 个月时，患者的肾脏和胰腺功能正常，组织学评估未发现移植物持续损伤的证据。这次成功的移植表明，当包含补体抑制剂依库丽单抗时，无需大量预处理即可安全地克服 ABO 障碍。
We describe the presumably first intentional ABO-incompatible deceaseddonor 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.