Journal article
Bortezomib in the treatment of antibody-mediated rejection in pediatric kidney transplant recipients: A multicenter Midwest Pediatric Nephrology Consortium study
Pediatric transplantation, Vol.21(3), pp.e12873-n/a
05/2017
DOI: 10.1111/petr.12873
PMID: 28092129
Abstract
Antibody-mediated rejection leads to allograft loss after kidney transplantation. Bortezomib has been used in adults for the reversal of antibody-mediated rejection; however, pediatric data are limited. This retrospective study was conducted in collaboration with the Midwest Pediatric Nephrology Consortium. Pediatric kidney transplant recipients who received bortezomib for biopsy-proven antibody-mediated rejection between 2008 and 2015 were included. The objective was to characterize the use of bortezomib in pediatric kidney transplant recipients. Thirty-three patients received bortezomib for antibody-mediated rejection at nine pediatric kidney transplant centers. Ninety percent of patients received intravenous immunoglobulin, 78% received plasmapheresis, and 78% received rituximab. After a median follow-up of 15 months, 65% of patients had a functioning graft. The estimated glomerular filtration rate improved or stabilized in 61% and 36% of patients at 3 and 12 months post-bortezomib, respectively. The estimated glomerular filtration rate at diagnosis significantly predicted estimated glomerular filtration rate at 12 months after adjusting for chronic histologic changes (P .001). Fifty-six percent of patients showed an at least 25% reduction in the mean fluorescence intensity of the immune-dominant donor-specific antibody, 1-3 months after the first dose of bortezomib. Non-life-threatening side effects were documented in 21 of 33 patients. Pediatric kidney transplant recipients tolerated bortezomib without life-threatening side effects. Bortezomib may stabilize estimated glomerular filtration rate for 3-6 months in pediatric kidney transplant recipients with antibody-mediated rejection.
Details
- Title: Subtitle
- Bortezomib in the treatment of antibody-mediated rejection in pediatric kidney transplant recipients: A multicenter Midwest Pediatric Nephrology Consortium study
- Creators
- Sarah Kizilbash - University of MinnesotaDonna Claes - Cincinnati Children's Hospital Medical CenterIsa Ashoor - Children's Hospital of New OrleansAshton Chen - Wake Forest UniversitySara Jandeska - Rush UniversityRaed Bou Matar - Cleveland ClinicJason Misurac - University of IowaJoseph Sherbotie - University of UtahKatherine Twombley - Medical University of South CarolinaPriya Verghese - University of Minnesota
- Resource Type
- Journal article
- Publication Details
- Pediatric transplantation, Vol.21(3), pp.e12873-n/a
- DOI
- 10.1111/petr.12873
- PMID
- 28092129
- ISSN
- 1397-3142
- eISSN
- 1399-3046
- Grant note
- UL1 TR001425 / NCATS NIH HHS
- Language
- English
- Date published
- 05/2017
- Academic Unit
- Nephrology, Dialysis and Transplantation; Stead Family Department of Pediatrics
- Record Identifier
- 9984353798402771
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