Successful Salvage Treatment of Resistant Acute Antibody-Mediated Kidney Transplant Rejection with Eculizumab
Journal Title: Sultan Qaboos University Medical Journal - Year 2016, Vol 16, Issue 3
Abstract
Antibody-mediated rejection (ABMR) jeopardises short- and long-term transplant survival and remains a challenge in the feld of organ transplantation. We report the frst 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. Te 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. Te patient became dialysis-free with serum Cr levels of 119 µmol/L within four months. Tis case report indicates that eculizumab is a promising agent in the treatment of ABMR.
Authors and Affiliations
Saif A. Khan| Departments of Medicine, Sultan Qaboos University Hospital, Dawood Al-Riyami| Departments of Medicine, Sultan Qaboos University Hospital, Yasser W. Al-Mula Abed| Departments of Medicine, Sultan Qaboos University Hospital, Saja Mohammed| Departments of Medicine, Sultan Qaboos University Hospital, Marwa Al-Riyami| Departments of Pathology, Sultan Qaboos University Hospital, Nabil M. Al-Lawati| Department of Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
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