February 23, 2012

Reduction of alloantibodies via proteosome inhibition in cardiac transplantation


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HLA antibodies produced by plasma cells are a major barrier for patients awaiting heart transplantation due to increased wait list time, increased risk of rejection post-transplant, and decreased survival. Proteasome inhibition using bortezomib can lead to plasma cell apoptosis and potentially decrease antibody production. As already shown in renal transplants where bortezomib decreases antibody production of certain HLA antibodies, this study shows the first clinical experience of bortezomib and plasmapheresis in heart transplants albeit in a small cohort of seven patients undergoing desensitization. The results show a mean cPRA reduction from 62% to 35% with a noted relapse in DSA in most of the patients and a higher incidence of infection leading to sepsis and death of two patients.

Cardiac Transplantation

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