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Prompt reversal of a severe complement activation by eculizumab in a patient undergoing intentional ABO-incompatible pancreas and kidney transplantation
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
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2011 (English)In: Transplant International, ISSN 0934-0874, E-ISSN 1432-2277, Vol. 24, no 8, e61-e66 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2011. Vol. 24, no 8, e61-e66 p.
Keyword [en]
ABO-incompatible pancreas and kidney transplantation, accommodation, complement activation, Eculizumab
National Category
Surgery
Research subject
Pathology
Identifiers
URN: urn:nbn:se:uu:diva-155664DOI: 10.1111/j.1432-2277.2011.01290.xISI: 000292462000001PubMedID: 21696455OAI: oai:DiVA.org:uu-155664DiVA: diva2:427444
Available from: 2011-06-28 Created: 2011-06-28 Last updated: 2015-08-13Bibliographically approved

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Biglarnia, Ali-RezaNilsson, Bovon Zur-Mühlen, BengtBerne, ChristianWanders, AlkwinMagnusson, AndersTufveson, Gunnar

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Biglarnia, Ali-RezaNilsson, Bovon Zur-Mühlen, BengtBerne, ChristianWanders, AlkwinMagnusson, AndersTufveson, Gunnar
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Transplantation SurgeryClinical ImmunologyDepartment of Medical SciencesClinical diabetology and metabolismMolecular and Morphological PathologyRadiology
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