Use of Bortezomib as Anti-Humoral Therapy in Kidney Transplantation.
10.3346/jkms.2014.29.5.648
- Author:
Keun Suk YANG
1
;
Howook JEON
;
Youngjae PARK
;
Ik Hyun JO
;
Ji Il KIM
;
In Sung MOON
;
Bum Soon CHOI
;
Cheol Whee PARK
;
Chul Woo YANG
;
Yong Soo KIM
;
Byung Ha CHUNG
Author Information
1. Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. chungbh@catholic.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Kidney Transplantation;
Bortezomib;
Anti-Humoral Therapy;
Desensitization;
Antibody Mediated Rejection
- MeSH:
Adult;
Boronic Acids/*therapeutic use;
Desensitization, Immunologic/*methods;
Female;
Graft Rejection/*drug therapy/*prevention & control;
HLA Antigens/immunology;
Humans;
Kidney/surgery;
Kidney Transplantation/*methods;
Male;
Middle Aged;
Pyrazines/*therapeutic use;
Treatment Outcome
- From:Journal of Korean Medical Science
2014;29(5):648-651
- CountryRepublic of Korea
- Language:English
-
Abstract:
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 (< or = 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.
