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

 Juhan Lee  ;  Beom Seok Kim  ;  Yongjung Park  ;  Jae Geun Lee  ;  Beom Jin Lim  ;  Hyeon Joo Jeong  ;  Yu Seun Kim  ;  Kyu Ha Huh 
 Yonsei Medical Journal, Vol.56(6) : 1638-1642, 2015 
Journal Title
 Yonsei Medical Journal 
Issue Date
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.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
김범석(Kim, Beom Seok) ORCID logo https://orcid.org/0000-0002-5732-2583
김유선(Kim, Yu Seun) ORCID logo https://orcid.org/0000-0002-5105-1567
박용정(Park, Yong Jung)
이재근(Lee, Jae Geun) ORCID logo https://orcid.org/0000-0002-6722-0257
이주한(Lee, Ju Han)
임범진(Lim, Beom Jin) ORCID logo https://orcid.org/0000-0003-2856-0133
정현주(Jeong, Hyeon Joo) ORCID logo https://orcid.org/0000-0002-9695-1227
허규하(Huh, Kyu Ha) ORCID logo https://orcid.org/0000-0003-1364-6989
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