硼替佐米治疗肝移植术后急性抗体介导排斥反应。
Bortezomib for acute antibody-mediated rejection in liver transplantation.
机构信息
Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center at Dallas, TX, USA.
出版信息
Am J Transplant. 2012 Sep;12(9):2526-31. doi: 10.1111/j.1600-6143.2012.04126.x. Epub 2012 Jun 8.
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.
摘要
抗体介导的排斥反应（AMR）是实体器官移植后一种不常见但具有挑战性的排斥反应类型。我们回顾了 3 例 ABO 血型相容肝移植受者的 AMR 病例。这些病例的特点是类固醇和抗胸腺细胞球蛋白耐药的严重急性排斥反应、浆细胞浸润的组织学证据、C4d 阳性和高血清抗 HLA 供体特异性抗体。所有 3 名患者均接受硼替佐米（一种有效耗竭浆细胞的蛋白酶体抑制剂）治疗。治疗后，所有患者的肝功能检查均改善或恢复正常，C4d 沉积得到解决，HLA 供体特异性抗体显著下降。
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