Korean J Med.
2011 Dec;81(6):780-785.
Proteasome-Inhibitor-Based Primary Therapy for Antibody-Mediated Rejection in a Renal Transplant Recipient
- Affiliations
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- 1Department of Internal Meidicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
- 2Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
- 3Division of Nephrology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. skpark@amc.seoul.kr
Abstract
- Donor-specific anti-human leukocyte antigen antibodies (DSA) following kidney transplantation predict the evolution of humoral rejection and reduced graft survival. Rapid, complete elimination of DSA during antibody-mediated rejection (AMR) is rarely achieved with traditional antihumoral therapies. We report the case of a 39-year-old female who was admitted for increasing azotemia and diagnosed with AMR based on diffusely positive histological changes on C4d immunostaining. In this case, bortezomib reversed the histological changes and induced a reduction in DSA. Proteasome-inhibitor-based combination therapy is a potential means for rapid DSA elimination in antibody-mediated rejection in renal transplant recipients.
MeSH Terms
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Adult
Antibodies
Azotemia
Boronic Acids
Complement C4b
Female
Graft Survival
HLA Antigens
Humans
Kidney Transplantation
Leukocytes
Peptide Fragments
Proteasome Inhibitors
Pyrazines
Rejection (Psychology)
Transplants
Bortezomib
Antibodies
Boronic Acids
Complement C4b
HLA Antigens
Peptide Fragments
Proteasome Inhibitors
Pyrazines
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