Early and Late Acute Antibody-Mediated Rejection Differ Immunologically and in Response to Proteasome Inhibition

摘要: Background. The efficacy of plasma cell targeted therapies for antibody-mediated rejection (AMR) has not been defined in detail. purpose this study was to compare early and late acute AMR terms immunologic characteristics responses with proteasome inhibitor (PI) therapy. Methods. Renal transplant recipients were treated PI-based regimens. Early as occurring within 6 months posttransplant. Immunodominant donor-specific antibody (iDSA) the DSA highest level. Results. Results are expressed or AMR. Thirty episodes (13 early, 17 late) 12 16 patients. but associated presensitization. Late iDSA levels higher, specificities primarily class II (DQ being most frequent). patients demonstrated greater reduction at 7, 14, 30 days posttreatment nadir (81.5%+21.2% vs. 51.4%+27.6%; P<0.01). more likely demonstrate histologic resolution/improvement (87.5% 53.8%; P=0.13). Both groups significant improvement renal function. Conclusions. exhibit distinct respond differently PI