Zahran Somaya, Podymow Tiina, Sandal Shaifali, Nodzynski Thomas, Matte Catherine, Cantarovich Marcelo
Division of Nephrology, McGill University, D5.7176 - 1001 Boul Decarie, Montreal, QC, H4A 3J1, Canada.
Research Institute of the McGill University Health Centre, Montreal, Canada.
J Nephrol. 2025 Jul 11. doi: 10.1007/s40620-025-02342-1.
Eculizumab, a monoclonal antibody targeting C5, is used to treat atypical hemolytic uremic syndrome (aHUS) and prevent recurrence post-kidney transplant (KTx). However, clinical experience with its use during pregnancy in kidney transplant recipients remains limited. We report a case of a 36-year-old woman with a history of aHUS and a high-risk complement factor H gene mutation who received a KTx and was treated with maintenance eculizumab post-transplant for the prevention of aHUS recurrence, and who later became pregnant. Eculizumab maintenance was continued during pregnancy. The patient delivered a healthy infant who developed normally; allograft function was well-preserved with no recurrence of thrombotic microangiopathy during pregnancy or in the 8 years postpartum. We reviewed the literature for similar cases and herein propose a structured approach to managing pregnant KTx recipients with a history of aHUS receiving eculizumab.
依库珠单抗是一种靶向补体C5的单克隆抗体，用于治疗非典型溶血性尿毒症综合征（aHUS）并预防肾移植（KTx）后复发。然而，其在肾移植受者孕期使用的临床经验仍然有限。我们报告了一例36岁女性病例，该患者有aHUS病史且存在高风险的补体因子H基因突变，接受了肾移植，并在移植后接受依库珠单抗维持治疗以预防aHUS复发，随后怀孕。孕期继续使用依库珠单抗维持治疗。患者分娩出一名健康婴儿，发育正常；移植肾功能良好，孕期及产后8年均未出现血栓性微血管病复发。我们查阅了类似病例的文献，并在此提出一种结构化方法，用于管理有aHUS病史且接受依库珠单抗治疗的怀孕肾移植受者。
