| _version_ | 1867016515505618944 |
|---|---|
| author | Mehmet Kanbay Sidar Copur Zeynep Y. Yilmaz Dilek Ertoy Baydar Ilmay Bilge Caner Susal Burak Kocak Alberto Ortiz |
| author_facet | Mehmet Kanbay Sidar Copur Zeynep Y. Yilmaz Dilek Ertoy Baydar Ilmay Bilge Caner Susal Burak Kocak Alberto Ortiz Mehmet Kanbay Sidar Copur Zeynep Y. Yilmaz Dilek Ertoy Baydar Ilmay Bilge Caner Susal Burak Kocak Alberto Ortiz |
| collection | Wiley Open Access |
| contents | The role of anticomplement therapy in the management of the kidney allograft Mehmet Kanbay Sidar Copur Zeynep Y. Yilmaz Dilek Ertoy Baydar Ilmay Bilge Caner Susal Burak Kocak Alberto Ortiz Clinical Transplantation AbstractAs the number of patients living with kidney failure grows, the need also grows for kidney transplantation, the gold standard kidney replacement therapy that provides a survival advantage. This may result in an increased rate of transplantation from HLA‐mismatched donors that increases the rate of antibody‐mediated rejection (AMR), which already is the leading cause of allograft failure. Plasmapheresis, intravenous immunoglobulin therapy, anti‐CD20 therapies (i.e., rituximab), bortezomib and splenectomy have been used over the years to treat AMR as well as to prevent AMR in high‐risk sensitized kidney transplant recipients. Eculizumab and ravulizumab are monoclonal antibodies targeting the C5 protein of the complement pathway and part of the expanding field of anticomplement therapies, which is not limited to kidney transplant recipients, and also includes complement‐mediated microangiopathic hemolytic anemia, paroxysmal nocturnal hemoglobinuria, and ANCA‐vasculitis. In this narrative review, we summarize the current knowledge concerning the pathophysiological background and use of anti‐C5 strategies (eculizumab and ravulizumab) and C1‐esterase inhibitor in AMR, either to prevent AMR in high‐risk desensitized patients or to treat AMR as first‐line or rescue therapy and also to treat de novo thrombotic microangiopathy in kidney transplant recipients. 10.1111/ctr.15277 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/ctr.15277 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_ctr_15277 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2024 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | The role of anticomplement therapy in the management of the kidney allograft Mehmet Kanbay Sidar Copur Zeynep Y. Yilmaz Dilek Ertoy Baydar Ilmay Bilge Caner Susal Burak Kocak Alberto Ortiz Clinical Transplantation The role of anticomplement therapy in the management of the kidney allograft Mehmet Kanbay Sidar Copur Zeynep Y. Yilmaz Dilek Ertoy Baydar Ilmay Bilge Caner Susal Burak Kocak Alberto Ortiz Clinical Transplantation AbstractAs the number of patients living with kidney failure grows, the need also grows for kidney transplantation, the gold standard kidney replacement therapy that provides a survival advantage. This may result in an increased rate of transplantation from HLA‐mismatched donors that increases the rate of antibody‐mediated rejection (AMR), which already is the leading cause of allograft failure. Plasmapheresis, intravenous immunoglobulin therapy, anti‐CD20 therapies (i.e., rituximab), bortezomib and splenectomy have been used over the years to treat AMR as well as to prevent AMR in high‐risk sensitized kidney transplant recipients. Eculizumab and ravulizumab are monoclonal antibodies targeting the C5 protein of the complement pathway and part of the expanding field of anticomplement therapies, which is not limited to kidney transplant recipients, and also includes complement‐mediated microangiopathic hemolytic anemia, paroxysmal nocturnal hemoglobinuria, and ANCA‐vasculitis. In this narrative review, we summarize the current knowledge concerning the pathophysiological background and use of anti‐C5 strategies (eculizumab and ravulizumab) and C1‐esterase inhibitor in AMR, either to prevent AMR in high‐risk desensitized patients or to treat AMR as first‐line or rescue therapy and also to treat de novo thrombotic microangiopathy in kidney transplant recipients. 10.1111/ctr.15277 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | The role of anticomplement therapy in the management of the kidney allograft |
| topic | Clinical Transplantation |
| url | https://onlinelibrary.wiley.com/doi/10.1111/ctr.15277 |