PMID- 36661196
OWN - NLM
STAT- MEDLINE
DCOM- 20230412
LR  - 20230509
IS  - 1399-0012 (Electronic)
IS  - 0902-0063 (Linking)
VI  - 37
IP  - 4
DP  - 2023 Apr
TI  - Efficacy of bortezomib desensitization among heart transplant candidates.
PG  - e14907
LID - 10.1111/ctr.14907 [doi]
AB  - Allosensitization is prevalent in heart transplant candidates and is associated 
      with prolonged waiting times and poor outcomes following transplantation. We 
      analyzed the efficacy of a desensitization regimen consisting of plasma exchange, 
      intravenous immunoglobulin, and bortezomib among 25 consecutive sensitized 
      waitlisted candidates at our center from 2016 to 2021. Following desensitization 
      therapies, all C1q negative antibodies were removed from a candidate's 
      unacceptable antigen list. There was a significant decrease in the median number 
      of human leukocyte antigen (HLA) class I (21-15, p = .001) but not class II 
      antibodies (7-6.5, p = .07). There was a significant corresponding decrease in 
      median calculated panel reactive antibodies for class I (90%-74%, p = .004) but 
      not class II (74.5%-75.5%, p = .30). Following desensitization, 76% of patients 
      were transplanted at a median of 91 days. One-year survival following transplant 
      was 89% with a 33% rate of antibody-mediated rejection (AMR). In conclusion, a 
      bortezomib desensitization protocol was modestly effective for class I antibodies 
      and allowed successful transplant in most cases when combined with selective 
      crossing of C1q negative antigens.
CI  - (c) 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Brinkley, D Marshall
AU  - Brinkley DM
AUID- ORCID: 0000-0002-9511-7767
AD  - Division of Cardiovascular Medicine, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
FAU - Mangione, MariaSanta
AU  - Mangione M
AD  - Department of Medicine, University of Texas Southwestern Medical Center, Dallas, 
      Texas, USA.
FAU - Fossey, Sallyanne C
AU  - Fossey SC
AD  - Dialysis Clinic, Inc., Transplant Immunology Laboratory, Nashville, Tennessee, 
      USA.
FAU - Harrison, Kimberly M
AU  - Harrison KM
AD  - Division of Cardiovascular Medicine, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
FAU - Zalawadiya, Sandip
AU  - Zalawadiya S
AD  - Division of Cardiovascular Medicine, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
FAU - Rali, Aniket S
AU  - Rali AS
AUID- ORCID: 0000-0002-3778-9979
AD  - Division of Cardiovascular Medicine, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
FAU - Siddiqi, Hasan K
AU  - Siddiqi HK
AD  - Division of Cardiovascular Medicine, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
FAU - Lindenfeld, JoAnn
AU  - Lindenfeld J
AD  - Division of Cardiovascular Medicine, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
FAU - Schlendorf, Kelly H
AU  - Schlendorf KH
AD  - Division of Cardiovascular Medicine, Vanderbilt University Medical Center, 
      Nashville, Tennessee, USA.
LA  - eng
PT  - Journal Article
DEP - 20230202
PL  - Denmark
TA  - Clin Transplant
JT  - Clinical transplantation
JID - 8710240
RN  - 69G8BD63PP (Bortezomib)
RN  - 80295-33-6 (Complement C1q)
RN  - 0 (Antibodies)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (HLA Antigens)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Humans
MH  - Bortezomib/therapeutic use
MH  - *Complement C1q
MH  - Antibodies
MH  - Immunoglobulins, Intravenous/therapeutic use
MH  - *Heart Transplantation
MH  - HLA Antigens
MH  - Desensitization, Immunologic/methods
MH  - Graft Rejection/drug therapy/etiology
MH  - Isoantibodies
OTO - NOTNLM
OT  - alloantibody
OT  - antibody-mediated (ABMR)
OT  - desensitization
OT  - immunosuppressant
OT  - other
OT  - rejection
EDAT- 2023/01/21 06:00
MHDA- 2023/04/12 06:42
CRDT- 2023/01/20 06:33
PHST- 2023/01/01 00:00 [revised]
PHST- 2022/09/20 00:00 [received]
PHST- 2023/01/02 00:00 [accepted]
PHST- 2023/04/12 06:42 [medline]
PHST- 2023/01/21 06:00 [pubmed]
PHST- 2023/01/20 06:33 [entrez]
AID - 10.1111/ctr.14907 [doi]
PST - ppublish
SO  - Clin Transplant. 2023 Apr;37(4):e14907. doi: 10.1111/ctr.14907. Epub 2023 Feb 2.