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KMID : 0882420110810060780
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Korean Journal of Medicine
2011 Volume.81 No. 6 p.780 ~ p.785
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Proteasome-Inhibitor-Based Primary Therapy for Antibody-Mediated Rejection in a Renal Transplant Recipient
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Park Se-Jeong
Yu Hoon
Baek Seung-Don
Baek Chung-Hee
Jeong Jae-Ho
Park Su-Kil
Kang Sung-Hee
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Abstract
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Donor-specific anti-human leukocyte antigen antibodies (DSA) following kidney transplantation predict the evolution of humoral rejection and reduced graft survival. Rapid, complete elimination of DSA during antibody-mediated rejection (AMR) is rarely achieved with traditional antihumoral therapies. We report the case of a 39-year-old female who was admitted for increasing azotemia and diagnosed with AMR based on diffusely positive histological changes on C4d immunostaining. In this case, bortezomib reversed the histological changes and induced a reduction in DSA. Proteasome-inhibitor-based combination therapy is a potential means for rapid DSA elimination in antibody-mediated rejection in renal transplant recipients.
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KEYWORD
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Proteasome inhibitors, Complement C4d, Human leukocyte antigens, Kidney transplantation
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