Eculizumab for the Treatment of Severe Antibody-Mediated Rejection: A Case Report and Review of the Literature

In renal transplantation, treatment options for antibody-mediated rejection are limited. Here, we report a case of severe AMR treated with eculizumab. A 50-year-old woman known for end stage kidney disease secondary to IgA nephropathy received a kidney transplant from a 50-year-old deceased donor. A...

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Bibliographic Details
Main Authors: Duy Tran, Anne Boucher, Suzon Collette, Alexis Payette, Virginie Royal, Lynne Senécal
Format: Article
Language:English
Published: Hindawi Limited 2016-01-01
Series:Case Reports in Transplantation
Online Access:http://dx.doi.org/10.1155/2016/9874261
Description
Summary:In renal transplantation, treatment options for antibody-mediated rejection are limited. Here, we report a case of severe AMR treated with eculizumab. A 50-year-old woman known for end stage kidney disease secondary to IgA nephropathy received a kidney transplant from a 50-year-old deceased donor. At 5 months after transplantation, she presented with acute graft dysfunction and biopsy showed a severe antibody-mediated rejection associated with thrombotic microangiopathy. Despite an aggressive conventional immunosuppressive regimen, signs of rejection persisted and the patient was treated with 3 doses of eculizumab. Following the therapy, markers of TMA improved and graft function stabilized. However, ongoing signs of rejection remained in the repeated biopsy. In kidney transplantation, eculizumab is an expensive treatment and its role in the treatment of antibody-mediated rejection remains to be determined.
ISSN:2090-6943
2090-6951