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Therapeutic dosingtiming and efficacy of bortezomib for antibody-mediated kidney transplant rejection / 中华器官移植杂志
Article in Chinese | WPRIM | ID: wpr-791837
Responsible library: WPRO
ABSTRACT
Objective To explore whether therapeutic dosing timing of proteasome inhibitor bortezomib(BZ) would impact its clinical efficacy .Methods From 2012 to 2018 ,35 biopsy-confirmed cases of acute antibody-mediated kidney transplant rejection (AMR) were collected .They received intravenous immunoglobulin (IVIG) plus sirolimus (Sir) plus bortezomib (BZ) .Three groups were assigned according to dosing timing of BZ .After a diagnosis of AMR ,ET (early treatment ) group began BZ dosing within 7 days (n=16) while DT (delayed treatment) group within 8-14 days (n=11) and LT (late treatment) group > 14 days (n= 8).Their clinical parameters and incidence of complications were analyzed .Results DSA reversal rate of ET ,DT and LT groups was 87 .5% , 45 .5% and 25 .0% (P=0 .006) while DSA declining rate 93 .8% ,90 .9% and 50% respectively (P=0 .019);recurrent rate of AMR was lower in ET/DT group than LT group (6 .6% vs 10% vs 75% , P=0 .042) .No significant differences existed in blood perfusion score of allograft at 1 month post-dosing among three groups .In three groups ,creatinine (Cr) of ET group was lower than DT group at month 1/3/12 while DT group was lower than LT group .No significant difference existed in the incidence of adverse reactions among 3 groups .Conclusions More likely to enter the window period , early dosing of BZ is more effective for treating acute AMR .An earlier intervention yields a better efficacy .

Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Organ Transplantation Year: 2019 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Organ Transplantation Year: 2019 Type: Article