期刊
HLA
卷 92, 期 -, 页码 47-50出版社
WILEY
DOI: 10.1111/tan.13387
关键词
antibody-mediated rejection; Bortezomib; donor-specific antibodies; intravenous immunoglobulins; plasmapheresis
资金
- Ministerstvo Zdravotnictvi Ceske Republiky [00023001]
A novel therapeutic approach to refractory acute antibody-mediated rejection (AMR) in kidney transplant recipients was applied in 23 patients based on administration of Bortezomib, intravenous corticosteroids, plasmapheresis and Rituximab. Application of Bortezomib regimen led to diminishing of donor-specific antibodies (DSA) to HLA-B (P = 0.004) and HLA-DR (P = 0.0005), but not to HLA-A (P = 0.106) and HLA-DQ antigens (P = 0.18). Patients with good clinical response to treatment had significantly better allograft survival than recipients with continuing deterioration of graft function (P = 0.019). Graft survival after therapy of refractory AMR was significantly worse than survival after first transplantation and was comparable with outcomes after retransplantation. In conclusion, therapy with Bortezomib was well tolerated and effective in decreasing the levels of HLA-B and -DR antibodies, however, was not successful in depleting HLA-A and -DQ DSA.
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