Bortezomib-Containing Regimen for Primary Treatment of Early Antibody-Mediated Cardiac Allograft Rejection: A Case Report. (June 2015)

• Record Type: Journal Article
• Authors: Gazdic, Tomas; Svobodova, Eva; Kubanek, Milos; Kment, Martin; Pagacova, Libuse; Viklicky, Ondrej; Malek, Ivan; Kautzner, Josef
• Is Part Of: Progress in transplantation. Volume 25:Number 2(2016)
• Page Start: 147
• Page End: 152
• Publication Date: 2015-06
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation; Organ Procurement; Tissue Donors; Transplantation of organs, tissues, etc; Electronic journals; Periodicals; Periodicals; 362.1783
• DOI: 10.7182/pit2015934
• Languages: English
• ISSNs: 1526-9248

Abstract

Evidence regarding the use of bortezomib-containing schemes in primary treatment of antibody-mediated rejection in heart transplant recipients is scarce. This case report presents the clinical experience with upstream use of bortezomib in primary treatment of early antibody-mediated rejection in an adult heart transplant recipient. Two cycles of bortezomib together with methylprednisolone, immunoadsorption, rituximab, and supplementary doses of intravenous immunoglobulin G reversed signs of heart failure, production of donor-specific antibodies, and findings of antibody-mediated rejection in biopsy. This treatment regimen was tolerated with only mild hematologic toxicity and proved to be successful during a 12-month follow-up. Primary treatment with a bortezomib-containing regimen appears to be a new therapeutic option for severe antibody-mediated rejection in heart transplant recipients. However, the efficacy and safety of this treatment need to be tested in prospective trials.