Bortezomib Provides Effective Therapy for Antibody- and Cell-Mediated Acute Rejection

Everly, Matthew J; Everly, J; Süßkind, B.; Brailey, Paul; Arend, Lois J.; Alloway, Rita R.; Roy‐Chaudhury, Prabir; Govil, Amit; Mogilishetty, G.; Rike, Adele; Cardi, M.; Wadih, George; Tevar, Amit D.; Woodle, E. Steve

doi:10.1097/tp.0b013e318190af83

Cited by 366 publications

(306 citation statements)

References 26 publications

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“…Matinlauri IH, H€ ockerstedt KA, Isoniemi HM. Equal overall rejection rate in pre-transplant flow-cytometric cross- Increasing data C4d deposition in microvasculature Abundant data 37,38 Increasing data DSA subtypes, C1q binding Emerging data [67][68][69] Limited data Microvascular inflammation Emerging data [70][71][72] [77][78][79] No analogous data Therapeutic trials designed to prevent DSA-associated injury Several studies [80][81][82] None 524 TANER, STEGALL, AND HEIMBACH LIVER TRANSPLANTATION, May 2014…”

Section: Discussionmentioning

confidence: 99%

Antibody-mediated rejection in liver transplantation: Current controversies and future directions

2014

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Section: Discussionmentioning

confidence: 99%

Antibody-mediated rejection in liver transplantation: Current controversies and future directions

2014

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“…However, the major advantage of PI has been in overcoming humoral barriers. 78,79 Eckman and associates demonstrated that a bortezomib-based regimen provided effective therapy for late, refractory AMR in a heart transplant adult recipient, and it was well tolerated. This remarkably positive experience, despite the refractory nature of the AMR episode, argues strongly for continuing to evaluate bortezomib use in these patients.…”

Section: Novel Approaches On Sensitized Patientsmentioning

confidence: 99%

Current Concepts in Histocompatibility During Heart Transplant

Picascia

Grimaldi²,

Zullo³

et al. 2012

Exp Clin Transplant

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Sensitized candidates for heart transplant usually end up on a long waiting list and have an increased risk of rejection, graft loss, and incidence of cardiac allograft vasculopathy. An increasing number of studies have demonstrated the negative effect of preformed and posttransplant antibodies on graft survival. Thus, in sensitized patients, the combination of new, appropriate, desensitization protocols, and monitoring of posttransplant development of donor-specific antibodies may improve short-term and long-term outcomes. Introduction of more-sensitive and more-specific techniques for antibody detection provides a valid tool for assessing the degree of pretransplant HLA histocompatibility, and, therefore, predicting the results of crossmatch in sensitized patients, which are difficult to transplant. Currently, there are no accurate and standard methods to determine the functional characteristics of antibodies detected by solid-phase assay and, therefore, to predict their clinical relevance. Therefore, the future of heart transplantation requires a better understanding of tissue typing techniques and the effect of anti-HLA antibodies on clinical outcome to prevent discrimination against sensitized patients at the time of organ allocation.

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“…15,16 Uncontrolled randomised studies have shown benefit in both rituximab and bortezomib. 11,17 These agents are usually used in conjunction with IVIG and/or PLEX.…”

Section: Discussionmentioning

confidence: 99%

Successful Salvage Treatment of Resistant Acute Antibody-Mediated Kidney Transplant Rejection with Eculizumab

Khan

Al-Riyami

Abed

et al. 2016

SQUMJ

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Antibody-mediated rejection (ABMR) jeopardises short-and long-term transplant survival and remains a challenge in the field of organ transplantation. We report the first use of the anticomplement agent eculizumab in Oman in the treatment of a 61-year-old female patient with ABMR following a living unrelated kidney transplant. The patient was admitted to the Sultan Qaboos University Hospital in Muscat, Oman, in 2013 on the eighth day post-transplantation with serum creatinine (Cr) levels of 400 µmol/L which continued to rise, necessitating haemodialysis. A biopsy indicated ABMR with acute cellular rejection. No improvement was observed following standard ABMR treatment and she continued to require dialysis. Five doses of eculizumab were administered over six weeks with a subsequent dramatic improvement in renal function. The patient became dialysis-free with serum Cr levels of 119 µmol/L within four months. This case report indicates that eculizumab is a promising agent in the treatment of ABMR.

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Bortezomib Provides Effective Therapy for Antibody- and Cell-Mediated Acute Rejection

Abstract: Bortezomib therapy: (1) provides effective treatment of AMR and ACR with minimal toxicity and (2) provides sustained reduction in iDSA and non-iDSA levels. Bortezomib represents the first effective antihumoral therapy with activity in humans that targets plasma cells.

Cited by 366 publications

References 26 publications

Antibody-mediated rejection in liver transplantation: Current controversies and future directions

Antibody-mediated rejection in liver transplantation: Current controversies and future directions

Current Concepts in Histocompatibility During Heart Transplant

Successful Salvage Treatment of Resistant Acute Antibody-Mediated Kidney Transplant Rejection with Eculizumab

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