Bortezomib With Steroid Pulse Therapy for Acute Cellular Rejection in Kidney Transplantation

Bortezomib With Steroid Pulse Therapy for Acute Cellular Rejection in Kidney

The purpose of this study is to determine whether bortezomib is effective in the treatment of acute cellular rejection after kidney transplantation.

When acute cellular rejection occurred in kidney allograft, investigators administer high dose steroid. However, there is insufficient effect in about 20-30%. Bortezomib acts not only on plasma cells, but also T cells, B cells and dendritic cells. In addition, bortezomib is relatively safe drug compared to thymoglobulin which investigators use in the cases of steroid failure. Therefore, investigators administer bortezomib with steroid in one group, and compared the group with the other group in which conventional steroid treatment is done.

Inclusion Criteria:

• living donor kidney transplantation recipients
• patients who were performed kidney biopsies because of laboratory and clinically suspected rejection
• Biopsy proven acute cellular rejection (Banff I - IIA) with C4d negative
• Single luminex panel reactive antibody (PRA) I & II mean fluorescent intensity (MFI) < 3000

Exclusion Criteria:

• patients who received other major organ transplantation
• combined with urinary tract infection or obstruction
• combined with acute antibody mediated rejection
• poor compliance