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Physiological and therapeutic complement regulators in kidney transplantation

Roumenina, Lubka T.a,b,c; Zuber, Julienb,d; Frémeaux-Bacchi, Véroniquea,e

Current Opinion in Organ Transplantation: August 2013 - Volume 18 - Issue 4 - p 421–429
doi: 10.1097/MOT.0b013e32836370ce
RENAL TRANSPLANTATION: Edited by Antoine Durrbach

Purpose of review This review will summarize the key contribution of complement regulators in the immune response to an allograft.

Recent findings Over the past 10 years, compelling evidences have been accumulated in support of a critical role of complement in the pathological phenomena related to organ transplantation. In addition to recurrence of complement-mediated disease after graft, complement is involved in situations as diverse as brain death induced tissue damages, ischaemia–reperfusion and antibody-mediated rejections. This complement activation is counterbalanced by various regulatory mechanisms.

Summary We discuss the role of physiological and therapeutic complement regulators that are designed to overcome the impact of complement overactivation with the aim of improving long-term transplant outcomes. We will focus primarily on renal allograft, but the discussed mechanisms take place to a different degree in any kind of organ transplantation.

aINSERM UMRS 872, Centre de Recherche des Cordeliers

bUniversité Paris Descartes Sorbonne Paris-Cité

cUniversité Pierre et Marie Curie (UPMC-Paris-6)

dHôpital Necker, Service de Transplantation

eAssistance Publique–Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service d’Immunologie Biologique, Paris, France

Correspondence to Dr Véronique Fremeaux-Bacchi, Service d’Immunologie Biologique, Hôpital Européen Georges Pompidou, 20–40 rue Leblanc, 75908 Paris cedex 15, France. Tel: +33 1 56 09 39 41; fax: +33 1 56 09 20 80; e-mail:

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins