Elimination of Post-transplant Donor-specific HLA Antibodies with Bortezomib.

Idica A, Kaneku H, Everly MJ, Trivedi HL, Feroz A, Vanikar AV, Shankar V, Trivedi VB, Modi PR, Khemchandani SI, Dave SD, Terasaki PI.

Clinical Transplants 2008, Chapter 21

Abstract

We show the ability of bortezomib to remove donor-specific HLA antibody from kidney allograft patients, the drug acting as a proteasome inhibitor, providing targeted therapy against antibody-producing plasma cells. Ten out of thirteen patients (77%) experienced primary DSA reversal, and in the remaining three patients the MFI of their primary DSA was dramatically reduced. Bortezomib is a viable therapy to treat donor-specific HLA antibody in allograft recipients. The potential for long-term benefits--and complications--are still unknown. Prospective trials are being conducted at the University of Cincinnati, Cincinnati, OH; at the Mayo Clinic, Rochester, MN; and at IKDRC-ITS, Ahmedabad, India.