Proteasome-Inhibitor-Based Primary Therapy for Antibody-Mediated Rejection in a Renal Transplant Recipient.
- Author:
Se Jeong PARK
1
;
Hoon YU
;
Sung Hee KANG
;
Seung Don BAEK
;
Chung Hee BAEK
;
Jae Ho JEONG
;
Su Kil PARK
Author Information
1. Department of Internal Meidicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Proteasome inhibitors;
Complement C4d;
Human leukocyte antigens;
Kidney transplantation
- MeSH:
Adult;
Antibodies;
Azotemia;
Boronic Acids;
Complement C4b;
Female;
Graft Survival;
HLA Antigens;
Humans;
Kidney Transplantation;
Leukocytes;
Peptide Fragments;
Proteasome Inhibitors;
Pyrazines;
Rejection (Psychology);
Transplants;
Bortezomib
- From:Korean Journal of Medicine
2011;81(6):780-785
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Donor-specific anti-human leukocyte antigen antibodies (DSA) following kidney transplantation predict the evolution of humoral rejection and reduced graft survival. Rapid, complete elimination of DSA during antibody-mediated rejection (AMR) is rarely achieved with traditional antihumoral therapies. We report the case of a 39-year-old female who was admitted for increasing azotemia and diagnosed with AMR based on diffusely positive histological changes on C4d immunostaining. In this case, bortezomib reversed the histological changes and induced a reduction in DSA. Proteasome-inhibitor-based combination therapy is a potential means for rapid DSA elimination in antibody-mediated rejection in renal transplant recipients.
