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Prompt reversal of a severe complement activation by eculizumab in a patient undergoing intentional ABO-incompatible pancreas and kidney transplantation

Biglarnia, Ali-Reza LU orcid ; Nilsson, Bo ; Nilsson, Thomas LU ; von Zur-Mühlen, Bengt ; Wagner, Michael ; Berne, Christian ; Wanders, Alkwin ; Magnusson, Anders and Tufveson, Gunnar (2011) In Transplant international : official journal of the European Society for Organ Transplantation 24(8). p.6-61
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... (More)

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 included.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
ABO Blood-Group System/immunology, Adult, Antibodies, Monoclonal, Humanized/pharmacology, Blood Group Incompatibility/immunology, Complement Activation, Complement System Proteins, Diabetes Mellitus/therapy, Enzyme-Linked Immunosorbent Assay/methods, Humans, Immunophenotyping/methods, Immunosuppressive Agents/therapeutic use, Kidney Transplantation/methods, Male, Pancreas Transplantation/methods, Renal Insufficiency/complications
in
Transplant international : official journal of the European Society for Organ Transplantation
volume
24
issue
8
pages
6 - 61
publisher
Springer
external identifiers
  • scopus:79960120521
  • pmid:21696455
ISSN
1432-2277
DOI
10.1111/j.1432-2277.2011.01290.x
language
English
LU publication?
yes
additional info
© 2011 The Authors. Transplant International © 2011 European Society for Organ Transplantation.
id
af105b2a-9562-429a-bd3a-c3a258caf537
date added to LUP
2025-12-17 14:19:50
date last changed
2025-12-19 02:25:41
@article{af105b2a-9562-429a-bd3a-c3a258caf537,
  abstract     = {{<p>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 included.</p>}},
  author       = {{Biglarnia, Ali-Reza and Nilsson, Bo and Nilsson, Thomas and von Zur-Mühlen, Bengt and Wagner, Michael and Berne, Christian and Wanders, Alkwin and Magnusson, Anders and Tufveson, Gunnar}},
  issn         = {{1432-2277}},
  keywords     = {{ABO Blood-Group System/immunology; Adult; Antibodies, Monoclonal, Humanized/pharmacology; Blood Group Incompatibility/immunology; Complement Activation; Complement System Proteins; Diabetes Mellitus/therapy; Enzyme-Linked Immunosorbent Assay/methods; Humans; Immunophenotyping/methods; Immunosuppressive Agents/therapeutic use; Kidney Transplantation/methods; Male; Pancreas Transplantation/methods; Renal Insufficiency/complications}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{6--61}},
  publisher    = {{Springer}},
  series       = {{Transplant international : official journal of the European Society for Organ Transplantation}},
  title        = {{Prompt reversal of a severe complement activation by eculizumab in a patient undergoing intentional ABO-incompatible pancreas and kidney transplantation}},
  url          = {{http://dx.doi.org/10.1111/j.1432-2277.2011.01290.x}},
  doi          = {{10.1111/j.1432-2277.2011.01290.x}},
  volume       = {{24}},
  year         = {{2011}},
}