Abstract
Antibody-mediated rejection (AMR) is an uncommon, but challenging type of rejection after solid organ transplantation. We review three cases of AMR in ABO-compatible liver transplant recipients. These cases were characterized by severe acute rejection resistant to steroids and antithymocyte globulin, histologic evidence of plasma cell infiltrates, C4d positivity and high serum anti-HLA donor-specific antibodies. All three patients were treated with bortezomib, a proteasome inhibitor effective in depleting plasma cells. After treatment, all patients had improved or normal liver function tests, resolution of C4d deposition and significant decline in their HLA donor-specific antibodies. This study reviews three cases of acute antibody-mediated rejection in ABO-compatible liver transplant recipients treated with proteasome-inhibitor therapy (bortezomib) with remarkable clinical, immunologic and histologic outcomes.
Original language | English (US) |
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Pages (from-to) | 2526-2531 |
Number of pages | 6 |
Journal | American Journal of Transplantation |
Volume | 12 |
Issue number | 9 |
DOIs | |
State | Published - Sep 2012 |
Keywords
- Antibody-mediated rejection
- HLA compatibility
- bortezomib
- crossmatch
- donor-specific antibodies
- liver transplantation
ASJC Scopus subject areas
- Immunology and Allergy
- Transplantation
- Pharmacology (medical)