Use of bortezomib as anti-humoral therapy in kidney transplantation.
This study aimed to investigate the effect of bortezomib in the desensitization and treatment of acute antibody mediated rejection (AAMR) in kidney transplantation. Nine patients who received bortezomib therapy for desensitization (DSZ group, n = 3) or treatment of AAMR (AAMR group, n = 6) were included in this study. In the DSZ group, 2 patients required DSZ owing to positive cross match and 1 owing to ABO mismatch with high baseline anti-ABO antibody titer (1:1,024). Bortezomib was used at 1, 3, 8, and 11 days from the start of the treatment. In the AAMR group, 3 patients showed full recovery of allograft function after bortezomib use and decrease in donor specific anti-HLA antibody (HLA-DSA). However, 3 patients did not respond to bortezomib and experienced allograft failure. In the DSZ group, negative conversion of T-CDC (complement-dependent cytotoxicity) was achieved, and HLA-DSA was decreased to lower than a weak level (median fluorescence intensity [MFI] < 5,000) in 2 patients. In the case of ABO mismatch kidney transplantation, the anti-A/B antibody titer decreased to below the target (≤ 1:16) after bortezomib therapy. Therefore, bortezomib could be an alternative therapeutic option for desensitization and treatment of AAMR that is unresponsive to conventional therapies.
['Yang|Keun Suk|KS|0000-0002-1340-961X', 'Jeon|Howook|H|', 'Park|Youngjae|Y|', 'Jo|Ik Hyun|IH|', 'Kim|Ji-Il|JI|', 'Moon|In Sung|IS|', 'Choi|Bum Soon|BS|', 'Park|Cheol Whee|CW|', 'Yang|Chul Woo|CW|', 'Kim|Yong-Soo|YS|', 'Chung|Byung Ha|BH|0000-0003-0048-5717']
D000328:Adult D001897:Boronic Acids D000069286:Bortezomib D003888:Desensitization, Immunologic D005260:Female D006084:Graft Rejection D006680:HLA Antigens D006801:Humans D007668:Kidney D016030:Kidney Transplantation D008297:Male D008875:Middle Aged D011719:Pyrazines D016896:Treatment Outcome
Bortezomib Anti-Humoral Therapy Kidney Transplantation Desensitization Antibody Mediated Rejection