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Eculizumab for atypical hemolytic uremic syndrome recurrence in renal transplantation.
- Source :
-
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2012 Dec; Vol. 12 (12), pp. 3337-54. Date of Electronic Publication: 2012 Sep 07. - Publication Year :
- 2012
-
Abstract
- Eculizumab (anti-C5) has been sporadically reported as an efficient therapy for atypical hemolytic uremic syndrome (aHUS). However, the lack of series precludes any firm conclusion about the optimal use of anti-C5 for preventing or treating aHUS posttransplant aHUS recurrence. We thoroughly studied 22 renal transplant recipients with aHUS who received off-label therapy with anti-C5, including 12 cases, which have not been reported yet. Nine patients, all carrying a complement genetic abnormality associated with a high risk of aHUS recurrence, received prophylactic anti-C5 therapy to prevent posttransplant recurrence. Eight of them had a successful recurrence-free posttransplant course and achieved a satisfactory graft function, while the remaining patient experienced early arterial thrombosis of the graft. Thirteen renal transplant recipients were given anti-C5 for posttransplant aHUS recurrence. A complete reversal of aHUS activity was obtained in all of them. Importantly, the delay of anti-C5 initiation after the onset of the aHUS episode inversely correlated with the degree of renal function improvement. Three patients in whom anti-C5 was subsequently stopped experienced a relapse. Altogether these data suggest that long-term eculizumab is highly effective for preventing and treating posttransplant aHUS recurrence. Our study also indicates that anti-C5 should be promptly started if a recurrence occurs.<br /> (© Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.)
- Subjects :
- Adolescent
Adult
Atypical Hemolytic Uremic Syndrome
Child
Child, Preschool
Complement C5 antagonists & inhibitors
Complement C5 immunology
Female
Hemolytic-Uremic Syndrome etiology
Humans
Infant
Male
Prognosis
Retrospective Studies
Young Adult
Antibodies, Monoclonal, Humanized therapeutic use
Hemolytic-Uremic Syndrome drug therapy
Kidney Transplantation adverse effects
Postoperative Complications
Secondary Prevention
Subjects
Details
- Language :
- English
- ISSN :
- 1600-6143
- Volume :
- 12
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 22958221
- Full Text :
- https://doi.org/10.1111/j.1600-6143.2012.04252.x