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Use of the terminal complement inhibitor eculizumab in paediatric heart transplant recipients

Published online by Cambridge University Press:  26 December 2019

Yuk M. Law Open the ORCID record for Yuk M. Law [Opens in a new window] ,
Deipanjan Nandi ,
Kimberly Molina ,
Katheryn Gambetta ,
Kevin P. Daly  and
Bibhuti Das
Yuk M. Law*
Affiliation:
Division of Pediatric Cardiology, Seattle Children’s Hospital, Seattle, WA, USA
Deipanjan Nandi
Affiliation:
Cardiology, Nationwide Children’s Hospital, Columbus, OH, USA
Kimberly Molina
Affiliation:
Pediatric Cardiology, Primary Children’s Hospital, Salt Lake City, UT, USA
Katheryn Gambetta
Affiliation:
Pediatric Cardiology, Ann and Robert H Lurie Children’s Hospital, Chicago, IL, USA
Kevin P. Daly
Affiliation:
Department of Cardiology, Boston Children’s Hospital & Department of Pediatrics, Harvard Medical School, Boston, MA, USA
Bibhuti Das
Affiliation:
Department of Pediatric Cardiology, Baylor College of Medicine, Texas Children’s Hospital, Austin, TX, USA
*
Author for correspondence: Yuk M. Law, Division of Pediatric Cardiology, Seattle Children’s Hospital, Seattle, WA, USA. Tel: 206-987-1417; Fax: 206-987-3839; E-mail: [email protected]
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Abstract

Antibody-mediated rejection is a major clinical challenge that limits graft survival. Various modalities of treatment have been reported in small studies in paediatric heart recipients. A novel approach is to use complement-inhibiting agents, such as eculizumab, which inhibits cleavage of C5 to C5a thereby limiting the formation of membrane attack complex and terminal complement-mediated injury of tissue-bound antibodies. This medical modality of treatment has theoretical advantages but the collective experience in its use in the solid organ transplant community remains small. We add to this experience by combining 14 cases from 6 paediatric heart centres in this descriptive study.

Keywords

Heart transplantationeculizumabmedical therapyantiboby-mediated rejectionchildrenpaediatrics
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 1 , January 2020 , pp. 107 - 113
Copyright
© Cambridge University Press 2019

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