PMID- 29214126
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220311
IS  - 2196-3029 (Print)
IS  - 2196-3029 (Electronic)
VI  - 4
IP  - 2
DP  - 2017
TI  - Pharmacologic Complement Inhibition in Clinical Transplantation.
PG  - 91-100
LID - 10.1007/s40472-017-0148-7 [doi]
AB  - PURPOSE OF REVIEW: Over the past two decades, significant strides made in our 
      understanding of the etiology of antibody-mediated rejection (AMR) in 
      transplantation have put the complement system in the spotlight. Here, we review 
      recent progress made in the field of pharmacologic complement inhibition in 
      clinical transplantation and aim to understand the impact of this therapeutic 
      approach on outcomes in transplant recipients. RECENT FINDINGS: Encouraged by the 
      success of agents targeting the complement cascade in disorders of unrestrained 
      complement activation like paroxysmal nocturnal hemoglobinuria (PNH) and atypical 
      hemolytic uremic syndrome (aHUS), investigators are testing the safety and 
      efficacy of pharmacologic complement blockade in mitigating allograft injury in 
      conditions ranging from AMR to recurrent post-transplant aHUS, C3 
      glomerulopathies and antiphospholipid anti-body syndrome (APS). A recent 
      prospective study demonstrated the efficacy of terminal complement inhibition 
      with eculizumab in the prevention of acute AMR in human leukocyte antigen 
      (HLA)-incompatible living donor renal transplant recipients. C1 esterase 
      inhibitor (C1-INH) was well tolerated in two recent studies in the treatment of 
      AMR and was associated with improved renal allograft function. SUMMARY: 
      Pharmacologic complement inhibition is emerging as valuable therapeutic tool, 
      especially in the management of highly sensitized renal transplant recipients. 
      Novel and promising agents that target various elements in the complement cascade 
      are in development. Graphical Abstractᅟ.
FAU - Tatapudi, Vasishta S
AU  - Tatapudi VS
AD  - Division of Nephrology, Department of Internal Medicine, NYU Langone Medical 
      Center, New York, NY 10016 USA. ISNI: 0000 0001 2109 4251. GRID: grid.240324.3
FAU - Montgomery, Robert A
AU  - Montgomery RA
AD  - NYU Langone Transplant Institute, 530 First Avenue, HCC 7A, New York, NY 10016 
      USA. ISNI: 0000 0004 1936 8753. GRID: grid.137628.9
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20170420
PL  - Switzerland
TA  - Curr Transplant Rep
JT  - Current transplantation reports
JID - 101624626
PMC - PMC5707230
OTO - NOTNLM
OT  - Antibody-mediated rejection
OT  - C1 inhibitor
OT  - Complement
OT  - Eculizumab
OT  - Kidney transplantation
COIS- CONFLICT OF INTEREST: Robert Montgomery received research grants from Alexion 
      (manufacturer of Soliris-Eculizumab) and Shire ViroPharma; served as a paid 
      consultant for Alexion, Shire ViroPharma and CSL, Behring; and received travel 
      honoraria from Alexion and Shire VioPharma during the conduct of this study. He 
      served on advisory boards for Genentech Scientific/ROCHE, True North/iPerian, 
      Novartis, and Hansa Medical; received consulting feels from OrbidMed, GuidePoint 
      Global, Sucampo, Astellas, and Shire; and received research grants from Immune 
      Tolerance Network, ViroPharma, Hansa and Alexion. Vasishta Tatapudi declares no 
      conflict of interest. HUMAN AND ANIMAL RIGHTS AND INFORMED CONSENT: This article 
      does not contain any studies with human or animal subjects performed by any of 
      the authors.
EDAT- 2017/12/08 06:00
MHDA- 2017/12/08 06:01
PMCR- 2017/04/20
CRDT- 2017/12/08 06:00
PHST- 2017/12/08 06:00 [entrez]
PHST- 2017/12/08 06:00 [pubmed]
PHST- 2017/12/08 06:01 [medline]
PHST- 2017/04/20 00:00 [pmc-release]
AID - 148 [pii]
AID - 10.1007/s40472-017-0148-7 [doi]
PST - ppublish
SO  - Curr Transplant Rep. 2017;4(2):91-100. doi: 10.1007/s40472-017-0148-7. Epub 2017 
      Apr 20.