Efficacy and safety of BORTEZOMIB treatment for refractory acute antibody-mediated rejection-a pilot study

HLA : Immune Response Genetics
Janka SlatinskaOndrej Viklicky

Abstract

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.

References

Jun 1, 1993·Kidney International·H E FeuchtE Albert
Nov 16, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J SellarésP F Halloran
Feb 4, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M MengelUNKNOWN Banff meeting report writing committee
May 2, 2013·Transplantation·Christina DörjeAnna Varberg Reisæter
Sep 27, 2013·The New England Journal of Medicine·Alexandre LoupyXavier Jouven
Jan 30, 2014·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M HaasUNKNOWN Banff meeting report writing committee

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