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Efficacy and safety of BORTEZOMIB treatment for refractory acute antibody‐mediated rejection—a pilot study
Author(s) -
Slatinska Janka,
Slavcev Antonij,
Honsova Eva,
Hruba Petra,
Kratochvilova Iva,
Rohal Tomas,
Viklicky Ondrej
Publication year - 2018
Publication title -
hla
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.347
H-Index - 99
eISSN - 2059-2310
pISSN - 2059-2302
DOI - 10.1111/tan.13387
Subject(s) - medicine , bortezomib , rituximab , plasmapheresis , refractory (planetary science) , regimen , antibody , transplantation , salvage therapy , human leukocyte antigen , gastroenterology , immunology , oncology , antigen , chemotherapy , multiple myeloma , physics , astrobiology
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.