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Targeting CD38 in subclinical antibody-mediated rejection in HLA-incompatible kidney transplantation: a case report

Title: Targeting CD38 in subclinical antibody-mediated rejection in HLA-incompatible kidney transplantation: a case report
Authors: Viklicky, Ondrej; Hruba, Petra; Novotny, Marek; Kment, Martin; Roder, Matej; Halloran, Philip F.; Boehmig, Georg A.
Publisher Information: Zenodo
Publication Year: 2024
Collection: Zenodo
Subject Terms: kidney transplantation; case report; HLA
Description: Presensitized patients with donor-specific antibodies (DSAs) are at increased risk of antibody-mediated rejection (AMR) of kidney allografts. The long-term consequences of AMR are serious because currently available therapeutic options lack lasting effectiveness. Targeting plasma cells to counter antibody production may hold promise for treating AMR. Daratumumab is a fully humanized monoclonal antibody directed against CD38, a glycoprotein expressed at high levels on plasma cells and, in addition, natural killer cells, which are suggested to act as effector cells in AMR. Several case reports suggested its efficacy in the treatment of AMR in patients with and without multiple myeloma. Timing of such therapy is of significant concern because serum creatinine alone cannot distinguish subclinical injury, and innovative tools are necessary for more precise diagnostics. Here, we describe a case of severe DSA rebound associated with subclinical AMR by histology and molecular assessments effectively reversed by a 6-mo course of daratumumab. ; This study was supported by the Ministry of Health of the Czech Republic (grant NU21-06-00021), its conceptual development of research organizations (Institute for Clinical and Experimental Medicine-IKEM, IN 00023001), and by the project National Institute for Research of Metabolic and Cardiovascular Diseases (Programme EXCELES, Project No. LX22NPO5104)—funded by the European Union—Next Generation EU.
Document Type: article in journal/newspaper
Language: English
ISSN: 2373-8731
Relation: https://zenodo.org/communities/ikem/; https://zenodo.org/communities/cardia/; https://zenodo.org/records/13325590; oai:zenodo.org:13325590; https://doi.org/10.1097/TXD.0000000000001685
DOI: 10.1097/TXD.0000000000001685
Availability: https://doi.org/10.1097/TXD.0000000000001685; https://zenodo.org/records/13325590
Rights: Creative Commons Attribution 4.0 International ; cc-by-4.0 ; https://creativecommons.org/licenses/by/4.0/legalcode
Accession Number: edsbas.78B73D97
Database: BASE