Bortezomib for acute antibody-mediated rejection in liver transplantation

F. Paterno, M. Shiller, G. Tillery, J. G. O'Leary, B. Susskind, J. Trotter, G. B. Klintmalm

Research output: Contribution to journalArticlepeer-review

58 Scopus citations


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 languageEnglish (US)
Pages (from-to)2526-2531
Number of pages6
JournalAmerican Journal of Transplantation
Issue number9
StatePublished - Sep 2012


  • Antibody-mediated rejection
  • HLA compatibility
  • bortezomib
  • crossmatch
  • donor-specific antibodies
  • liver transplantation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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