Gene

Complement component 5

Complement system

Biology

Acquired immune system

Transplantation

Complement (music)

Biochemistry

Classical complement pathway

Immunology

Monoclonal antibody

Complementation

Immune system

Complement receptor

Internal medicine

Organ transplantation

Eculizumab

Medicine

Innate immune system

Antibody

Alternative complement pathway

Phenotype

Transplantation Reviews

The complement system is a major constituent of the innate immune system. It has a critical role in defense against pathogens but dysregulation of complement activation may lead to tissue injury and modulate the adaptive immune response. In organ transplantation, local complement activation is involved in hyper-acute rejection and antibody-mediated rejection. This last decade, interest in complement activation has increased due to new insights into the pathophysiology of antibody-mediated rejection, but also since the availability of news drugs that target terminal complement activation. In this review, we discuss our current understanding of how local complement activation induces acute and chronic graft injury, and review recent advances in clinical trials that block complement activation using the anti-C5 monoclonal antibody, eculizumab. Finally, we discuss how complement-targeted therapy may be integrated into our current immunosuppressive regimen and what type of patient will benefit most from this therapy.

Complement modulation in solid-organ transplantation