ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2020
Desensitizing highly sensitized heart transplant candidates with the combination of belatacept and proteasome inhibition.
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05145296 (Non-Randomized, Single-Center Pilot Trial Assessing The Safety/Efficacy Of Targeting Peripheral And Central Humoral Alloimmune Memory With Daratumumab And With Belatacept In Highly HLA-Sensitized Patients Awaiting Kidney Transplantation), which is not on this map. Cited by 20 papers.
What it found
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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.
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.
Non-Randomized, Single-Center Pilot Trial Assessing The Safety/Efficacy Of Targeting Peripheral And Central Humoral Alloimmune Memory With Daratumumab And With Belatacept In Highly HLA-Sensitized Patients Awaiting Kidney Transplantation
Who cites it
20 citing papers in PubMed, 45 citations in OpenAlex.
- Reversing pregnancy-induced B cell sensitization to facilitate the induction of transplant tolerance in postpartum recipients.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2026Article
- Article
- Heart Transplantation: Immunological Challenges Revisited.Current cardiology reviews · 2026Review
- Treatment of antibody-mediated rejection in heart transplantation: from empirical combination to multi-target precision intervention.Frontiers in immunology · 2026Review
- Desensitization Strategies in Immunized Heart Transplant Recipients.European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes · 2026Review
- Belatacept-based immunosuppression in heart transplant recipients: A single center experience.JHLT open · 2025Article
- Review
- Belatacept in Kidney Transplantation: Reflecting on the Past, Shaping the Future.Transplant international : official journal of the European Society for Organ Transplantation · 2025Review
- Impacts of Pre-transplant Panel-Reactive Antibody on Post-transplantation Outcomes: A Study of Nationwide Heart Transplant Registry Data.Korean circulation journal · 2024Article
- An Unexpectedly High Incidence of Invasive Fungal Diseases in Solid Organ Transplant Recipients Taking Belatacept for Organ Rejection Prophylaxis: A Single-Center Retrospective Cohort Study.Open forum infectious diseases · 2024Article
- Desensitization and belatacept-based maintenance therapy in pregnancy-sensitized monkeys receiving a kidney transplant.Science advances · 2023Article
- Novel insights in the clinical management of hyperimmune patients before and after transplantation.Current research in immunology · 2023Review
- From bench to bedside: reversing established antibody responses and desensitization.Current opinion in organ transplantation · 2022Review
- Toward an understanding of allogeneic conflict in pregnancy and transplantation.The Journal of experimental medicine · 2022Review
- Antibody-mediated rejection after kidney transplantation in children; therapy challenges and future potential treatments.Clinical transplantation · 2022Review
- Adaptive immune cell responses as therapeutic targets in antibody-mediated organ rejection.Trends in molecular medicine · 2022Review
- Novel Immunosuppression in Solid Organ Transplantation.Handbook of experimental pharmacology · 2022Article
- Targeting T Follicular Helper Cells to Control Humoral Allogeneic Immunity.Transplantation · 2021Review
- Lung Transplantation and the Era of the Sensitized Patient.Frontiers in immunology · 2021Review
- Current Desensitization Strategies in Heart Transplantation.Frontiers in immunology · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
HLA antibodies pose a significant barrier to transplantation and current strategies to reduce allosensitization are limited. We hypothesized that augmenting proteasome inhibitor (PI) based desensitization with costimulation blockade (belatacept) to mitigate germinal center (GC) responses might increase efficacy and prevent rebound. Four highly sensitized (calculated panel reactive antibody [cPRA] class I and/or II >99%, complement-dependent cytotoxicity panel reactive antibody [CDC PRA+], C1q+) heart transplant candidates were treated with the combination of belatacept and PI therapy, which significantly reduced both class I and II HLA antibodies and increased the likelihood of identifying an acceptable donor. Three negative CDC crossmatches were achieved against 3, 6, and 8 donor-specific antibodies (DSA), including those that were historically C1q+ binding. Posttransplant, sustained suppression of 3 of 3, 4 of 6, and 8 of 8 DSA (cases 1-3) was achieved. Analysis of peripheral blood mononuclear cells before and after desensitization in one case revealed a decrease in naïve and memory B cells and a reduction in T follicular helper cells with a phenotype suggesting recent GC activity (CD38, PD1, and ICOS). Furthermore, a shift in the natural killer cell phenotype was observed with features suggestive of activation. Our findings support synergism between PI based desensitization and belatacept facilitating transplantation with a negative CDC crossmatch against historically strong, C1q binding antibodies.
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Registered trials
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.