Bortezomib Is Effective to Treat Acute Humoral Rejection After Liver Transplantation
Bortezomib Is Effective to Treat Acute Humoral Rejection After Liver Transplantation
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DOI：
10.1016/j.transproceed.2012.01.051
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发表时间：
2012-03-01
影响因子：
0.9
通讯作者：
Lee, W. -C.
中科院分区：
文献类型：
--
作者：
Lee, C. -F.;Eldeen, F. Z.;Lee, W. -C.
导论.急性体液性排斥反应（AHR）是原位肝移植（奥尔特）的一种罕见并发症，常规治疗效果不佳。硼替佐米是一种蛋白酶体抑制剂，已被证明可有效治疗浆细胞源性肿瘤和肾移植后急性排斥反应。在此，我们报告了我们的临床经验，硼替佐米作为一种新的方法来治疗AHR后OLT。我们回顾性分析了2007年1月至2011年4月期间进行的247例成人OLT。A组为AHR患者，接受类固醇冲击、利妥昔单抗（375 mg/m2）和血浆置换（PP）治疗。2009年3月后，B组受试者接受类固醇脉冲、ritindumab、PP和硼替佐米（1.3 mg/m2）。结果在9例（3.6%）确诊为AHR的患者中，A组（n = 3）所有患者均在AHR后数天内死亡，而B组6例中有4例（66.7%）患者抢救成功，3例（50%）患者存活，平均随访22.3个月（18-26个月）。基于蛋白酶体转运蛋白的治疗为奥尔特后AHR的治疗提供了更有效的策略。
Introduction. Acute humoral rejection (AHR), a rare complication in orthotopic liver transplantation (OLT), responds poorly to conventional therapies. Bortezomib, a proteasome inhibitor, has been shown to be effective in treating plasma cell derived tumors and acute rejection episodes after renal transplantation. Herein, we have reported our clinical experience with bortezomib as a novel approach to treat AHR after OLT.Methods. We retrospectively analyzed the 247 adult OLTs performed from January 2007 to April 2011. Patients with AHR who were treated with steroid pulses, rituximab (375 mg/m(2)), and plasmapheresis (PP) were assigned to group A. Group B subjects were prescribed steroid pulses, ritindmab, PP, and bortezomib (1.3 mg/m(2)), after March 2009. Results. Among the 9 patients (3.6%) diagnosed with AHR, all subjects in group A (n = 3) died within several days after AHR, whereas 4/6 (66.7%) group B patients were rescued and 3 (50%) survived at a mean follow-up 22.3 months (range, 18-26).Conclusion. Proteasome inhibitor-based therapies provide a more effective strategy to treat AHR after OLT.