Desensitization Using Bortezomib and High-dose Immunoglobulin Increases Rate of Deceased Donor Kidney Transplantation
DC Field | Value | Language |
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dc.contributor.author | Jeong, Jong Cheol | - |
dc.contributor.author | Jambaldorj, Enkthuya | - |
dc.contributor.author | Kwon, Hyuk Yong | - |
dc.contributor.author | Kim, Myung-Gyu | - |
dc.contributor.author | Im, Hye Jin | - |
dc.contributor.author | Jeon, Hee Jung | - |
dc.contributor.author | In, Ji Won | - |
dc.contributor.author | Han, Miyeun | - |
dc.contributor.author | Koo, Tai Yeon | - |
dc.contributor.author | Chung, Junho | - |
dc.contributor.author | Song, Eun Young | - |
dc.contributor.author | Ahn, Curie | - |
dc.contributor.author | Yang, Jaeseok | - |
dc.date.accessioned | 2021-09-04T03:22:32Z | - |
dc.date.available | 2021-09-04T03:22:32Z | - |
dc.date.created | 2021-06-18 | - |
dc.date.issued | 2016-02 | - |
dc.identifier.issn | 0025-7974 | - |
dc.identifier.uri | https://scholar.korea.ac.kr/handle/2021.sw.korea/89613 | - |
dc.description.abstract | Combination therapy of intravenous immunoglobulin (IVIG) and rituximab showed a good transplant rate in highly sensitized wait-listed patients for deceased donor kidney transplantation (DDKT), but carried the risk of antibody-mediated rejection. The authors investigated the impact of a new combination therapy of bortezomib, IVIG, and rituximab on transplantation rate. This study was a prospective, open-labeled clinical trial. The desensitization regimen consisted of 2 doses of IVIG (2 g/kg), a single dose of rituximab (375 mg/m(2)), and 4 doses of bortezomib (1.3 mg/m(2)). The transplant rate was analyzed. Anti-Human leukocyte antigen (HLA) DRB antibodies were determined by a Luminex solid-phase bead assay at baseline and after 2, 3, and 6 months in the desensitized patients. There were 19 highly sensitized patients who received desensitization and 17 patients in the control group. Baseline values of class I and II panel reactive antibody (%, peak mean fluorescence intensity) were 83 +/- 16.0 (14952 +/- 5820) and 63 +/- 36.0 (10321 +/- 7421), respectively. Deceased donor kidney transplantation was successfully performed in 8 patients (42.1%) in the desensitization group versus 4 (23.5%) in the control group. Multivariate time-varying covariate Cox regression analysis showed that desensitization increased the probability of DDKT (hazard ratio, 46.895; 95% confidence interval, 3.468-634.132; P = 0.004). Desensitization decreased mean fluorescence intensity values of class I panel reactive antibody by 15.5% (20.8%) at 2 months. In addition, a liberal mismatch strategy in post hoc analysis increased the benefit of desensitization in donor-specific antibody reduction. Desensitization was well tolerated, and acute rejection occurred only in the control group. In conclusion, a desensitization protocol using bortezomib, high-dose IVIG, and rituximab increased the DDKT rate in highly sensitized, wait-listed patients. | - |
dc.language | English | - |
dc.language.iso | en | - |
dc.publisher | LIPPINCOTT WILLIAMS & WILKINS | - |
dc.subject | INTRAVENOUS IMMUNOGLOBULIN | - |
dc.subject | PROTEASOME INHIBITION | - |
dc.subject | SENSITIZED PATIENTS | - |
dc.subject | PLASMA-CELLS | - |
dc.subject | RITUXIMAB | - |
dc.subject | ANTIBODY | - |
dc.subject | OUTCOMES | - |
dc.subject | NEPHROPATHY | - |
dc.subject | RECIPIENTS | - |
dc.subject | RISK | - |
dc.title | Desensitization Using Bortezomib and High-dose Immunoglobulin Increases Rate of Deceased Donor Kidney Transplantation | - |
dc.type | Article | - |
dc.contributor.affiliatedAuthor | Kim, Myung-Gyu | - |
dc.identifier.doi | 10.1097/MD.0000000000002635 | - |
dc.identifier.scopusid | 2-s2.0-84958811356 | - |
dc.identifier.wosid | 000370501900001 | - |
dc.identifier.bibliographicCitation | MEDICINE, v.95, no.5, pp.1 - 10 | - |
dc.relation.isPartOf | MEDICINE | - |
dc.citation.title | MEDICINE | - |
dc.citation.volume | 95 | - |
dc.citation.number | 5 | - |
dc.citation.startPage | 1 | - |
dc.citation.endPage | 10 | - |
dc.type.rims | ART | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.relation.journalResearchArea | General & Internal Medicine | - |
dc.relation.journalWebOfScienceCategory | Medicine, General & Internal | - |
dc.subject.keywordPlus | INTRAVENOUS IMMUNOGLOBULIN | - |
dc.subject.keywordPlus | PROTEASOME INHIBITION | - |
dc.subject.keywordPlus | SENSITIZED PATIENTS | - |
dc.subject.keywordPlus | PLASMA-CELLS | - |
dc.subject.keywordPlus | RITUXIMAB | - |
dc.subject.keywordPlus | ANTIBODY | - |
dc.subject.keywordPlus | OUTCOMES | - |
dc.subject.keywordPlus | NEPHROPATHY | - |
dc.subject.keywordPlus | RECIPIENTS | - |
dc.subject.keywordPlus | RISK | - |
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