Case Report

Eculizumab for the Treatment of Severe Antibody-Mediated Rejection: A Case Report and Review of the Literature

Table 1

Cases of antibody-mediated rejection treated with eculizumab.

PatientsRegimenOutcome

Locke et al. (2009) [5]20-yo male
Bone marrow transplant
Positive DSA
Positive crossmatch
1 dose (600 mg)Improvement in allograft function and AMR resolution in biopsy

Lonze et al. (2010) [6]43-yo female
Kidney pair exchange
Positive DSA
Positive crossmatch
8 doses (1200 mg × 4, 600 mg × 4)Normalization of allograft function

González-Roncero et al. (2012) [7]2 cases
49-yo male and 34 yo female
Low immunological risk
1 dose (600 mg)Improvement in allograft function

Noone et al. (2012) [8]13-yo female
High immunological risk
Factor H deficiency
2 doses (600 mg, 900 mg)Improvement in allograft function

Stewart et al. (2012) [9]29-yo male
ABO incompatibility
5 dosesImprovement in allograft function and resolution of AMR in biopsy

Kocak et al. (2013) [10]2 cases
26-yo female and 46-yo female
Positive DSA
5 doses (5 × 900 mg)Improvement in allograft function (only 1 recipient)

Burbach et al. (2014) [12]2 cases
43-yo female and 36-yo male
Positive DSA
Negative C4d in biopsy
6 doses (900 mg × 4, 1200 mg × 2)No improvement in allograft function

Chehade et al. (2015) [11]7-yo male
Positive DSA
2 doses (600 mg × 2)Normalization of allograft function

Current case (2015)50-yo female
Pretransplant positive DSA
Negative C4d in biopsy
3 doses (1200 mg × 1, 900 mg × 2)Transient stabilization of allograft function
Persistence of AMR in repeated biopsy

DSA: donor specific antibody.
yo: year-old.
AMR: antibody-mediated rejection.