Evidence map›Paper›PMID 38808699›Full record

ArticlePediatric transplantation2024

Bortezomib for antibody-mediated rejection of kidney transplant in youth: Associations with donor-specific antibody.

Rosanna Fulchiero, Lauren Galea, Jennifer Hewlett, Jonathan D Savant, Sonya Lopez, Sandra Amaral, Bernarda Viteri

Abstract read
In one paragraph

Article in Pediatric transplantation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

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

2 citing papers in PubMed.

  1. Review
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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

7 authors.

Rosanna FulchieroNephrology Division, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.ORCID 0000-0002-5757-6209
Lauren GaleaNephrology Division, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Jennifer HewlettNephrology Division, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Jonathan D SavantNephrology Division, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Sonya LopezNephrology Division, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Sandra AmaralNephrology Division, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.ORCID 0000-0001-7357-242X
Bernarda ViteriNephrology Division, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.ORCID 0000-0001-5566-0768

Funding

Clinical Pharmacoepidemiology Training ProgramT32GM075766 · NIGMS · UNIVERSITY OF PENNSYLVANIA · PI Sean Hennessy, Charles Edward Leonard · 2006 to 2026
$8.4M
Reaching Equity for Adults and CHildren in Transplant (REACH-TRANSPLANT)R01DK120886 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI AMARAL, SANDRA, KU, ELAINE · 2019 to 2023
$3.5M
VIRTUUS Children's Study: Validating Injury to the Renal Transplant Using Urinary Signatures in ChildrenR01HD091185 · NICHD · CHILDREN'S HOSP OF PHILADELPHIA · PI AMARAL, SANDRA, KEATING, BRENDAN JAMES · 2017 to 2021
$3.4M
IMPAKT Study: Imaging Modalities in Pediatric Assessments of Kidney TransplantsK23DK131331 · NIDDK · CHILDREN'S HOSP OF PHILADELPHIA · PI Bernarda Viteri Baquerizo · 2022 to 2026
$899k
Promoting Diversity and Sustainability in the NIDDK-Supported Research Workforce through Mentoring Early Career Investigators: Focus on Health EquityK26DK138377 · NIDDK · CHILDREN'S HOSP OF PHILADELPHIA · PI Sandra Amaral · 2023 to 2026
$478k
NICHD NIH HHS R01 HD091185NIDDK NIH HHS K23 DK131331NIDDK NIH HHS K26 DK138377NIDDK NIH HHS R01 DK120886NIGMS NIH HHS T32 GM075766
6 · The paper itself

Abstract

backgroundAntibody-mediated rejection is one of the most significant risk factors for allograft dysfunction and failure in children and adolescents with kidney transplants, yet optimal treatment remains unidentified. To date, there are mixed findings regarding the use of Bortezomib, a plasma cell apoptosis inducer, as an adjunct therapy in the treatment of antibody-mediated rejection.

methodsIn a retrospective single center study, we reviewed the efficacy and tolerability of bortezomib as adjunct therapy for treatment-refractory antibody-mediated rejection.

resultsSix patients with a median age of 14.6 years (range 6.9-20.1 years) received bortezomib at a mean of 71 months (range 15-83 months) post-kidney transplant. Four patients experienced decline in estimated glomerular filtration rate (eGFR) from 4% to 42%. One patient started bortezomib while on hemodialysis and did not recover graft function, and another patient progressed to hemodialysis 6 months after receiving bortezomib. Although DSA did not completely resolve, there was a statistically significant decline in DSA MFI pre and 12-months post-BZ (p = .012, paired t-test) for the subjects who were not on dialysis at the time of bortezomib. Chronic Allograft Damage Index (CADI) score of ≥3 was seen in all six subjects at their biopsy prior to therapy. No adverse effects were reported.

conclusionsBortezomib was well tolerated and resulted in improvements in MFI of DSA among four pediatric subjects without allograft failure, although no effects were observed on eGFR trajectory. Further studies are needed to clarify whether earlier intervention with bortezomib could prevent renal failure progression.

Indexed as

BortezomibGlomerular Filtration RateGraft RejectionKidney TransplantationAdolescentChildFemaleHumansImmunosuppressive AgentsIsoantibodiesMaleRetrospective StudiesTreatment OutcomeYoung AdultBortezomibImmunosuppressive AgentsIsoantibodiesantibody‐mediated rejectionbortezomibkidney transplantpediatrics

Identifiers

PMID38808699
PMCPMC11189613

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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.