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The Effect of Bortezomib on Antibody-Mediated Rejection after Kidney Transplantation.

Title
The Effect of Bortezomib on Antibody-Mediated Rejection after Kidney Transplantation.
Authors
Juhan Lee;Beom Seok Kim;Kyu Ha Huh;Yu Seun Kim;Hyeon Joo Jeong;Beom Jin Lim;Jae Geun Lee;Yongjung Park
Issue Date
2015
Journal Title
Yonsei Medical Journal
ISSN
0513-5796
Citation
Yonsei Medical Journal, Vol.56(6) : 1638~1642, 2015
Abstract
PURPOSE: Recently, bortezomib has been used to treat antibody-mediated rejection (AMR) refractory to conventional treatment such as plasmapheresis, intravenous immunoglobulin, and rituximab. The authors aimed to describe their experiences when bortezomib was used to treat refractory AMR. MATERIALS AND METHODS: Eleven refractory AMR episodes treated with bortezomib were included in this study. The patients received one or two cycles of bortezomib (1.3 mg/m²) on days 1, 4, 8, and 11. RESULTS: Bortezomib effectively reduced antibodies against various targets, including human leukocyte antigen (HLA) class I and II, ABO blood group antigen, and angiotensin II type 1 receptor. Antibodies were depleted or reduced significantly in eight AMR episodes. Overall, there was a significant improvement in the mean estimated glomerular filtration rate (eGFR) at 3 months after therapy (36.91±22.15 mL/min/1.73 m²) versus eGFR at time of AMR diagnosis (17.00±9.25 mL/min/1.73 m²; p=0.007). All six early-onset AMR episodes (within 6 months post-transplantation) showed full recovery of allograft function. Additionally, three of the five late-onset AMR episodes (>6 months post-transplantation) showed improved allograft function. CONCLUSION: Anti-humoral treatment based on bortezomib might be an effective strategy against refractory AMR caused by various types of antibodies. Notably, this treatment could be more effective in early-onset AMR than in late-onset AMR.
URI

http://ir.ymlib.yonsei.ac.kr/handle/22282913/141416
DOI
10.3349/ymj.2015.56.6.1638.
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Pathology
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
1. 연구논문 > 1. College of Medicine > Dept. of Laboratory Medicine
1. 연구논문 > 1. College of Medicine > Dept. of Surgery
Yonsei Authors
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