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Proteasome-Inhibitor-Based Primary Therapy for Antibody-Mediated Rejection in a Renal Transplant Recipient  

Park, Se-Jeong (Department of Internal Meidicine, University of Ulsan College of Medicine, Asan Medical Center)
Yu, Hoon (Department of Internal Meidicine, University of Ulsan College of Medicine, Asan Medical Center)
Kang, Sung-Hee (Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center)
Baek, Seung-Don (Department of Internal Meidicine, University of Ulsan College of Medicine, Asan Medical Center)
Baek, Chung-Hee (Department of Internal Meidicine, University of Ulsan College of Medicine, Asan Medical Center)
Jeong, Jae-Ho (Department of Internal Meidicine, University of Ulsan College of Medicine, Asan Medical Center)
Park, Su-Kil (Department of Division of Nephrology, University of Ulsan College of Medicine, Asan Medical Center)
Publication Information
The Korean Journal of Medicine / v.81, no.6, 2011 , pp. 780-785 More about this Journal
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.
Keywords
Proteasome inhibitors; Complement C4d; Human leukocyte antigens; Kidney transplantation;
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