title: Management of antibody-mediated rejection in transplantation.
abstract: Despite intensive traditional immunosuppressive therapy, rates of graft loss have approximated 15% to 20% at 1 year following antibody-mediated rejection (AMR) in solid organ transplant recipients. Therefore, the development of antihumoral therapies that provide prompt elimination of donor-specific anti-HLA antibodies and improve allograft survival is an important goal. Traditional treatment modalities for AMR deplete B-cell populations but not the cell at the source of antibody production, the mature plasma cell. Plasma cell-targeted therapies using proteasome inhibition is a novel approach to treating AMR. This review discusses current and emerging treatment modalities used for AMR.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, University of Cincinnati College of Medicine, 231 Albert Sabin Way, ML 558, Cincinnati, OH 45267-0558, USA.
authors.forename: Basma
authors.initials: B
authors.lastname: Sadaka
authors.forename: Rita R
authors.initials: RR
authors.lastname: Alloway
authors.forename: E Steve
authors.initials: ES
authors.lastname: Woodle
mesh_terms: D000906:Antibodies / Q000276:immunology*; D061067:Antibodies, Monoclonal, Humanized / Q000494:pharmacology / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D001897:Boronic Acids / Q000494:pharmacology / Q000627:therapeutic use; D000069286:Bortezomib; D006084:Graft Rejection / Q000276:immunology*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000494:pharmacology; D007155:Immunologic Factors / Q000494:pharmacology; D007163:Immunosorbent Techniques; D016030:Kidney Transplantation; D010950:Plasma Cells / Q000187:drug effects; D010956:Plasmapheresis; D011719:Pyrazines / Q000494:pharmacology / Q000627:therapeutic use; D000069283:Rituximab; D013156:Splenectomy
chemical_list: D000906:Antibodies; D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D001897:Boronic Acids; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D011719:Pyrazines; D000069283:Rituximab; D000069286:Bortezomib; C481642:eculizumab
keywords: Antibody-mediated rejection; Donor-specific antibodies; Kidney transplantation; Plasma cell