Eculizumab for antibody-mediated rejection in heart transplantation: A case-control study

Clin Transplant. 2021 Dec;35(12):e14454. doi: 10.1111/ctr.14454. Epub 2021 Sep 23.


Complement inhibition offers a novel treatment approach for antibody-mediated rejection (AMR). We examined patients with hemodynamic compromise AMR 2010-2020, comparing eight patients supplemented with eculizumab to 10 patients without; administration was at the treating physician's discretion. There were no significant differences between groups though eculizumab patients had a non-significantly higher inotrope score (208.8 mcg/kg/min vs. 2.6 mcg/kg/min; P = .22), more extracorporeal membrane oxygenation (ECMO) (62.5% vs. 20%; P = .066), and worse 1-year survival (37.5% vs. 60%; P = .63). The role of eculizumab is uncertain in AMR; multicenter collaborative studies are essential to better define its role.

Keywords: cardiovascular disease; heart (allograft) function/dysfunction; immunosuppressive regimens; rejection: antibody-mediated (ABMR).

Publication types

  • Multicenter Study

MeSH terms

  • Antibodies, Monoclonal, Humanized
  • Case-Control Studies
  • Complement Inactivating Agents
  • Graft Rejection / drug therapy
  • Graft Rejection / etiology
  • Heart Transplantation*
  • Humans
  • Isoantibodies
  • Kidney Transplantation*


  • Antibodies, Monoclonal, Humanized
  • Complement Inactivating Agents
  • Isoantibodies
  • eculizumab