Successful salvage treatment of resistant acute antibody-mediated kidney transplant rejection with eculizumab

Saif A. Khan, Dawood Al-Riyami, Yasser W. Al-Mula Abed, Saja Mohammed, Marwa Al-Riyami, Nabil M. Al-Lawati

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2 Citations (Scopus)

Abstract

Antibody-mediated rejection (ABMR) jeopardises short- and long-term transplant survival and remains a challenge in the field of organ transplantation. We report the first use of the anticomplement agent eculizumab in Oman in the treatment of a 61-year-old female patient with ABMR following a living unrelated kidney transplant. The patient was admitted to the Sultan Qaboos University Hospital in Muscat, Oman, in 2013 on the eighth day post-transplantation with serum creatinine (Cr) levels of 400 µmol/L which continued to rise, necessitating haemodialysis. A biopsy indicated ABMR with acute cellular rejection. No improvement was observed following standard ABMR treatment and she continued to require dialysis. Five doses of eculizumab were administered over six weeks with a subsequent dramatic improvement in renal function. The patient became dialysis-free with serum Cr levels of 119 µmol/L within four months. This case report indicates that eculizumab is a promising agent in the treatment of ABMR.

Original languageEnglish
Pages (from-to)e371-e374
JournalSultan Qaboos University Medical Journal
Volume16
Issue number3
DOIs
Publication statusPublished - Aug 1 2016

Fingerprint

Salvage Therapy
Graft Rejection
Kidney
Antibodies
Oman
Dialysis
Creatinine
Transplants
Organ Transplantation
Serum
Renal Dialysis
Therapeutics
Transplantation
eculizumab
Biopsy

Keywords

  • Case report
  • Complement activation
  • Eculizumab
  • Kidney transplantation
  • Oman
  • Transplantation rejection

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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abstract = "Antibody-mediated rejection (ABMR) jeopardises short- and long-term transplant survival and remains a challenge in the field of organ transplantation. We report the first use of the anticomplement agent eculizumab in Oman in the treatment of a 61-year-old female patient with ABMR following a living unrelated kidney transplant. The patient was admitted to the Sultan Qaboos University Hospital in Muscat, Oman, in 2013 on the eighth day post-transplantation with serum creatinine (Cr) levels of 400 µmol/L which continued to rise, necessitating haemodialysis. A biopsy indicated ABMR with acute cellular rejection. No improvement was observed following standard ABMR treatment and she continued to require dialysis. Five doses of eculizumab were administered over six weeks with a subsequent dramatic improvement in renal function. The patient became dialysis-free with serum Cr levels of 119 µmol/L within four months. This case report indicates that eculizumab is a promising agent in the treatment of ABMR.",
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AU - Al-Mula Abed, Yasser W.

AU - Mohammed, Saja

AU - Al-Riyami, Marwa

AU - Al-Lawati, Nabil M.

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AB - Antibody-mediated rejection (ABMR) jeopardises short- and long-term transplant survival and remains a challenge in the field of organ transplantation. We report the first use of the anticomplement agent eculizumab in Oman in the treatment of a 61-year-old female patient with ABMR following a living unrelated kidney transplant. The patient was admitted to the Sultan Qaboos University Hospital in Muscat, Oman, in 2013 on the eighth day post-transplantation with serum creatinine (Cr) levels of 400 µmol/L which continued to rise, necessitating haemodialysis. A biopsy indicated ABMR with acute cellular rejection. No improvement was observed following standard ABMR treatment and she continued to require dialysis. Five doses of eculizumab were administered over six weeks with a subsequent dramatic improvement in renal function. The patient became dialysis-free with serum Cr levels of 119 µmol/L within four months. This case report indicates that eculizumab is a promising agent in the treatment of ABMR.

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