Evidence map›Paper›PMID 27048228›Full record

ArticlePediatric nephrology (Berlin, Germany)2016

Bortezomib may stabilize pediatric renal transplant recipients with antibody-mediated rejection.

Meghan H Pearl, Anjali B Nayak, Robert B Ettenger, Dechu Puliyanda, Miguel Fernando Palma Diaz, Qiuheng Zhang, Elaine F Reed, Eileen W Tsai

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric nephrology (Berlin, Germany), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
4.0field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 31 citations in OpenAlex.

  1. Article
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  8. Observational
  9. Article
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  11. Recent advances in allograft vasculopathy.Current opinion in organ transplantation · 2017
    Review
  12. Article
  13. The lack of Lazarus effect with proteasome inhibition.Pediatric nephrology (Berlin, Germany) · 2016
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Meghan H PearlDepartment of Pediatrics, Division of Nephrology, David Geffen School of Medicine at UCLA, University of California Los Angeles, PO Box 951752, Los Angeles, CA, 90095, USA. mpearl@mednet.ucla.edu.
Anjali B NayakDepartment of Pediatrics, Division of Nephrology, David Geffen School of Medicine at UCLA, University of California Los Angeles, PO Box 951752, Los Angeles, CA, 90095, USA.
Robert B EttengerDepartment of Pediatrics, Division of Nephrology, David Geffen School of Medicine at UCLA, University of California Los Angeles, PO Box 951752, Los Angeles, CA, 90095, USA.
Dechu PuliyandaPediatric Nephrology and Transplant Immunology, Cedars Sinai Medical Center, Los Angeles, CA, USA.
Miguel Fernando Palma DiazDepartment of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, PO Box 951752, Los Angeles, CA, USA.
Qiuheng ZhangDepartment of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, PO Box 951752, Los Angeles, CA, USA.
Elaine F ReedDepartment of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, PO Box 951752, Los Angeles, CA, USA.
Eileen W TsaiDepartment of Pediatrics, Division of Nephrology, David Geffen School of Medicine at UCLA, University of California Los Angeles, PO Box 951752, Los Angeles, CA, 90095, USA.
University of California, Los Angeles · USCedars-Sinai Medical Center · US

Funding

Anti-MHC Effects on EndotheliumR01AI042819 · NIAID · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI REED, ELAINE F · 1999 to 2014
$4.0M
Translational Research Training in Pediatric NephrologyT32DK104687 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI SALUSKY, ISIDRO B. · 2015 to 2019
$879k
NIAID NIH HHS R01 AI042819NIDDK NIH HHS T32 DK104687
6 · The paper itself

Abstract

backgroundCurrent therapeutic strategies to effectively treat antibody-mediated rejection (AMR) are insufficient. Thus, we aimed to determine the benefit of a therapeutic protocol using bortezomib for refractory C4d + AMR in pediatric kidney transplant patients.

methodsWe examined seven patients with treatment-refractory C4d + AMR. Immunosuppression included antithymocyte globulin or anti-CD25 monoclonal antibody for induction therapy with maintenance corticosteroids, calcineurin inhibitor, and anti-metabolite. Estimated glomerular filtration rate (eGFR) calculated by the Schwartz equation, biopsy findings assessed by 2013 Banff criteria, and human leukocyte antigen (HLA) donor-specific antibodies (DSA) performed using the Luminex single antigen bead assay were monitored pre- and post- bortezomib therapy.

resultsSeven patients (86 % male, 86 % with ≥6/8 HLA mismatch, and 14 % with pre-formed DSA) age 5 to 19 (median 15) years developed refractory C4d + AMR between 1 and 145 (median 65) months post-transplantation. All patients tolerated bortezomib. One patient had allograft loss. Of the six patients with surviving grafts (86 %), mean pre-bortezomib eGFR was 42 ml/min/1.73 m(2) and the mean 1 year post-bortezomib eGFR was 53 ml/min/1.73 m(2). Five of seven (71 %) had improvement of histological findings of AMR, C4d staining, and/or acute cellular rejection. Reduction in HLA DSAs was more effective for class I than class II.

conclusionsBortezomib appears safe and may correlate with stabilization of eGFR in pediatric kidney transplant patients with refractory C4d + AMR.

Indexed as

Kidney TransplantationAdolescentBortezomibChild, PreschoolComplement C4bFemaleGraft RejectionGraft SurvivalHLA AntigensHumansMalePeptide FragmentsProteasome InhibitorsRetrospective StudiesYoung AdultBortezomibComplement C4bcomplement C4dHLA AntigensPeptide FragmentsProteasome InhibitorsAntibody-mediated rejectionBortezomibKidneyNon-adherencePediatricProteasome inhibitorTransplant

Identifiers

PMID27048228
PMCPMC5590841
OpenAlexW2329220952

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.