Pretransplant Desensitization with Costimulation Blockade and Proteasome Inhibitor Reduces DSA and Delays Antibody-Mediated Rejection in Highly Sensitized Nonhuman Primate Kidney Transplant Recipients.
Brian EzekianPaul M SchroderMichael S MulvihillAndrew BarbasBradley CollinsKyle FreischlagJanghoon YoonJohn S YiFelicitas SmithDanae OlasoFrances M SaccoccioSallie PermarAlton B FarrisJean KwunStuart J KnechtlePublished in: Journal of the American Society of Nephrology : JASN (2019)
Desensitization using proteasome inhibition and costimulation blockade reduces bone marrow plasma cells, disorganizes germinal center responses, reduces donor-specific antibody levels, and prolongs allograft survival in highly sensitized nonhuman primates. Most animals experienced antibody-mediated rejection with humoral-response rebound, suggesting desensitization must be maintained after transplantation using ongoing suppression of the B cell response.