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Eculizumab use in kidney transplantation
Christopher K Johnson1, Nicolae Leca
1Division of Nephrology, University of Washington, Seattle, Washington, USA.
Current Opinion in Organ Transplantation
|November 5, 2015
Summary
Eculizumab offers a breakthrough for complement-mediated disorders in kidney transplantation, particularly in atypical hemolytic uremic syndrome (aHUS). While effective, its use is limited by cost and requires further research for broader applications.
Area of Science:
- Nephrology
- Immunology
- Pharmacology
Background:
- Eculizumab inhibits complement system effector functions, offering a therapeutic advance for paroxysmal nocturnal hemoglobinuria and atypical hemolytic uremic syndrome (aHUS).
- Off-label use in complement-mediated disorders is constrained by high cost, despite potential applicability.
- Ongoing safety monitoring notes an increased risk of encapsulated organism infections.
Purpose of the Study:
- To review current data on eculizumab's use in kidney transplantation.
- To evaluate its efficacy and safety in various kidney diseases.
Main Methods:
- Review of existing clinical data and trials.
- Analysis of eculizumab's impact on specific kidney conditions.
Main Results:
- Eculizumab shows significant therapeutic impact in aHUS, reducing recurrence and allograft loss.
- Response in C3 glomerulopathies is heterogeneous; efficacy is less clear for upstream complement deregulation.
- Role in antibody-mediated rejection is uncertain due to limited use in complex cases.
Conclusions:
- Eculizumab highlights complement-mediated disorders as a therapeutic target in transplantation.
- Further research is essential to optimize eculizumab's application, efficacy, and monitoring in kidney transplantation.
- Future therapies targeting the complement system are anticipated.
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