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

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1638-1642
Number of pages5
JournalYonsei medical journal
Volume56
Issue number6
DOIs
Publication statusPublished - 2015 Nov

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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