Tasaki M, Saito K, Nakagawa Y, Nobushita T, Anraku T, Kuroki H, Imai N, Ito Y, Tomita Y. [THE USE OF BORTEZOMIB FOR THE TREATMENT OF
CHRONIC ANTIBODY MEDIATED REJECTION AFTER KIDNEY TRANSPLANTATION].
Nihon Hinyokika Gakkai Zasshi 2018;
109:68-73. [PMID:
31006744 DOI:
10.5980/jpnjurol.109.68]
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Abstract
(Backgrounds) The efficacy of bortezomib for chronic antibody mediated rejection (CAMR) after kidney transplantation is still obscure. (Materials and methods) CAMR were persisted in 5 recipients who were treated with plasma exchange, low dose of IVIG, steroid pulse therapy, and rituximab. 1.3 mg/m2 of bortezomib was administered on days 1, 4, 8, 11. Serum creatinine (sCr) levels, anti-HLA antibodies, and histology were analyzed. (Results) Stable sCr levels were obtained in 3 out of 5 recipients. No one lost renal graft function during follow-up periods. Anti-HLA class I antibodies were significantly decreased after bortezomib treatment, however anti-HLA class II antibodies were not changed. Histology showed no improvement at 6 months after bortezomib administration. Two recipients whose sCr levels increased during follow-up had already had interstitial fibrosis and tubular atrophy (IF/TA) in histology before bortezomib treatment. (Conclusions) The use of bortezomib after IF/TA could be detected in histology may not contribute to stabilize renal graft function in CAMR.
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