Prompt reversal of a severe complement activation by eculizumab in a patient undergoing intentional ABO‐incompatible pancreas and kidney transplantation
Ali-Reza Biglarnia,Bo Nilsson,Thomas Nilsson,Bengt von Zur-Mühlen,Michael Wagner,Christian Berne,Alkwin Wanders,Anders Magnusson,Gunnar Tufveson +8 more
Reads0
Chats0
TLDR
This potentially first intentional ABO‐incompatible deceased‐donor kidney and pancreas transplantation with a severe antibody‐mediated rejection during a rebound of isoagglutinins suggests that ABO barriers can be overcome without extensive preconditioning, when the complement inhibitor eculizumab is included.Abstract:
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 includedread more
Citations
More filters
Journal ArticleDOI
Compstatin: a C3-targeted complement inhibitor reaching its prime for bedside intervention
Dimitrios C. Mastellos,Despina Yancopoulou,Petros Kokkinos,Markus Huber-Lang,George Hajishengallis,Ali Reza Biglarnia,Florea Lupu,Bo Nilsson,Antonio M. Risitano,Daniel Ricklin,John D. Lambris +10 more
TL;DR: An up‐to‐date survey of the drug design effort placed on the compstatin family of C3 inhibitors, highlighting the most promising drug candidates and discusses translational challenges in complement drug discovery and peptide drug development.
Journal ArticleDOI
ABO-Incompatible Kidney Transplantation.
TL;DR: There is still concern, however, that infectious complications such as viral disease, Pneumocystis jirovecii pneumonia, and severe urinary tract infections are increased after ABOi transplantations.
Journal ArticleDOI
C1 Inhibitor in Acute Antibody-Mediated Rejection Nonresponsive to Conventional Therapy in Kidney Transplant Recipients: A Pilot Study.
Denis Viglietti,Clément Gosset,Alexandre Loupy,Laure Deville,Jérôme Verine,Adriana Zeevi,Denis Glotz,Carmen Lefaucheur +7 more
TL;DR: C1‐INH added to IVIG is safe and may improve allograft function in kidney recipients with nonresponsive acute ABMR that is nonresponsive to conventional therapy.
Journal ArticleDOI
Infections associated with the use of eculizumab: recommendations for prevention and prophylaxis.
Esther Benamu,Jose G. Montoya +1 more
TL;DR: Eculizumab has opened new horizons in the treatment of complement-mediated disorders and is expanding beyond complement- mediated diseases to transplantation and neurology, and prevention strategies against the risk of Neisseria spp.
Journal ArticleDOI
Eculizumab and splenectomy as salvage therapy for severe antibody-mediated rejection after HLA-incompatible kidney transplantation
Babak J. Orandi,Andrea A. Zachary,Nabil N. Dagher,Serena M. Bagnasco,Jacqueline Garonzik-Wang,Kyle J. Van Arendonk,Natasha Gupta,Bonnie E. Lonze,Nada Alachkar,Edward S. Kraus,Niraj M. Desai,Jayme E. Locke,Lorraine C. Racusen,Dorry L. Segev,Robert A. Montgomery +14 more
TL;DR: It is suggested that for patients manifesting early severe AMR, splenectomy plus eculizumab may provide an effective intervention for rescuing and preserving allograft function.
References
More filters
Journal ArticleDOI
Reshaping human antibodies for therapy.
TL;DR: A human IgGI antibody has been reshaped for serotherapy in humans by introducing the six hypervariable regions from the heavy- and light-chain variable domains of a rat antibody directed against human lymphocytes.
Journal ArticleDOI
Inhibition of complement activity by humanized anti-C5 antibody and single-chain Fv
Thomas C. Thomas,Scott A. Rollins,Russell P. Rother,Michelle A. Giannoni,Sandra L. Hartman,Eileen A. Elliott,Steven H. Nye,Louis A. Matis,Stephen P. Squinto,Mark J. Evans +9 more
TL;DR: These results demonstrate that humanized h5G1.1 and its recombinant derivatives retain both the affinity and blocking functions of the murine 5G 1.1 antibody, and suggest that these molecules may serve as potent inhibitors of complement-mediated pathology in human inflammatory diseases.
Journal ArticleDOI
Implementation of a Protocol for ABO-incompatible kidney transplantation--a three-center experience with 60 consecutive transplantations.
Gunnar Tydén,Johannes Donauer,Jonas Wadström,Gunilla Kumlien,Jochen Wilpert,Thomas Nilsson,Helena Genberg,Przemislaw Pisarski,Gunnar Tufveson +8 more
TL;DR: A significant inter-institutional variation in the measurement of anti-AB-antibodies was found, having a substantial impact on the number of immunoadsorptions and consequently on the total cost for the procedure.
Journal ArticleDOI
Pancreas transplantation in the United States: a review.
TL;DR: With modern immunosuppressive protocols and careful donor selection, patient survival rates and pancreas transplant graft function can be further improved in all three pancrea transplant categories.
Journal ArticleDOI
Generation of iC3 at the interface between blood and gas.
TL;DR: The rate of iC3/iC3 fragments generation was unaffected by the composition of the gas (pure oxygen, pure nitrogen or air), suggesting that the denaturation of C3 indeed occurred at the serum gas interface.
Related Papers (5)
The complement inhibitor eculizumab in paroxysmal nocturnal hemoglobinuria.
Peter Hillmen,Neal S. Young,Jörg Schubert,Robert A. Brodsky,Gérard Socié,Petra Muus,Alexander Röth,Jeff Szer,Modupe O. Elebute,Ryotaro Nakamura,Paul Browne,Antonio M. Risitano,Anita Hill,Hubert Schrezenmeier,Chieh Lin Fu,Jaroslaw P. Maciejewski,Scott A. Rollins,Christopher F. Mojcik,Russell P. Rother,Lucio Luzzatto +19 more