ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Eculizumab in the Treatment of Early Severe Acute Antibody Mediated Rejection Following HLA-Compatible Kidney Transplantation-Case Series

M. Singh,1 N. Macias,2 V. Tatapudi,1 B. Lee.1

1Transplant Nephrology, UCSF Medical Center, San Francisco, CA
2Nephrology, Hospital Gregorio Maranon, Madrid, Spain.

Meeting: 2015 American Transplant Congress

Abstract number: A132

Keywords: Graft function, Kidney transplantation, Monoclonal antibodies, Rejection

Session Information

Session Name: Poster Session A: Kidney Antibody Mediated Rejection

Session Type: Poster Session

Date: Saturday, May 2, 2015

Session Time: 5:30pm-7:30pm

 Presentation Time: 5:30pm-7:30pm

Location: Exhibit Hall E

Severe early acute antibody-mediated rejection (AMR) is associated with poor allograft outcomes. Eculizumab is a humanized mouse monoclonal antibody against complement factor C5 that has been successfully used in the field of transplantation to prevent recurrent atypical hemolytic uremic syndrome (aHUS) and more recently in antibody mediated rejection. Here, we report 5 cases of severe acute AMR within 2 weeks post transplant (4 kidney alone, one after simultaneous kidney-pancreas). Three of them had histologic evidence of thrombotic microangiopathy and two with failure to respond to the standard treatment who were successfully treated with 2-4 doses of eculizumab in addition to plasmapheresis, intravenous immunoglobulins (IVIG) +/- Rituximab. Two patients who were ABO incompatible underwent desensitization, and two were highly sensitized with calculated panel reactive antibody (cPRA) above 80%. All patients had negative flow cross-match and no anti-HLA donor specific antibodies pre-transplant. All patients received antithymocyte globulin induction therapy followed by standard maintenance immunosuppression with tacrolimus, mycophenolate mofetil/sodium, and prednisone. All patients responded within 2-3 days after eculizumab administration with improved allograft function. Three patients underwent 6 month protocol biopsy showing resolution of anti-allograft activity with no evidence of transplant glomerulopathy. At follow-up (9-23 months), all patients had a functioning allograft with mean serum creatinine 2.08 (1.17-4.75) mg/dl at 1 month, 1.15 (0.83-1.93) mg/dl at 3 months and 1.13 (1.06-1.73) mg/dl at 9-12 months.Our case series emphasizes the fact that eculizumab seems to be an effective therapy when used early in patients with severe acute AMR by inhibiting complement related graft injury without an apparent increased risk of infectious complications. Further studies are needed to establish the dosing and duration of eculizumab and to explore its cost effectiveness compared to other treatment modalities.

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Singh M, Macias N, Tatapudi V, Lee B. Eculizumab in the Treatment of Early Severe Acute Antibody Mediated Rejection Following HLA-Compatible Kidney Transplantation-Case Series [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/eculizumab-in-the-treatment-of-early-severe-acute-antibody-mediated-rejection-following-hla-compatible-kidney-transplantation-case-series/. Accessed May 8, 2025.

« Back to 2015 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences