Terminal complement inhibition decreases antibody-mediated rejection in sensitized renal transplant recipients.

摘要: Sensitized renal transplant recipients with high levels of donor-specific alloantibody (DSA) commonly develop antibody-mediated rejection (AMR), which may cause acute graft loss or shorten allograft survival. We examined the efficacy terminal complement inhibition humanized anti-C5 antibody, eculizumab, in prevention AMR a positive crossmatch against their living donor. The incidence biopsy-proven first 3 months posttransplant 26 highly sensitized donor transplants who received eculizumab was compared to historical control group 51 patients treated similar plasma exchange (PE)-based protocol without eculizumab. 7.7% (2/26) 41.2% (21/51) (p = 0.0031). Eculizumab also decreased developed DSA early after transplantation that caused proximal activation. With episodes were easily PE reducing need for splenectomy. On 1-year biopsy, glomerulopathy found be present 6.7% (1/15) eculizumab-treated and 35.7% (15/42) 0.044). Inhibition activation decreases (ClincalTrials.gov number NCT006707).