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Bortezomib for Acute Antibody‐Mediated Rejection in Liver Transplantation
Author(s) -
Paterno F.,
Shiller M.,
Tillery G.,
O’Leary J. G.,
Susskind B.,
Trotter J.,
Klintmalm G. B.
Publication year - 2012
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2012.04126.x
Subject(s) - medicine , bortezomib , antibody , transplantation , liver transplantation , abo blood group system , immunology , proteasome inhibitor , plasma cell , gastroenterology , multiple myeloma
Antibody‐mediated rejection (AMR) is an uncommon, but challenging type of rejection after solid organ transplantation. We review three cases of AMR in ABO‐compatible liver transplant recipients. These cases were characterized by severe acute rejection resistant to steroids and antithymocyte globulin, histologic evidence of plasma cell infiltrates, C4d positivity and high serum anti‐HLA donor‐specific antibodies. All three patients were treated with bortezomib, a proteasome inhibitor effective in depleting plasma cells. After treatment, all patients had improved or normal liver function tests, resolution of C4d deposition and significant decline in their HLA donor‐specific antibodies.