Daratumumab for Treatment of Antibody-Mediated Rejection after ABO-Incompatible Kidney Transplantation

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Abstract

We report the effectiveness of daratumumab, a human IgGκ monoclonal antibody targeting CD38 on plasma cells, for therapy-refractory antibody-mediated rejection (AMR) due to blood group antibodies in a 59-year-old man who received a living ABO-incompatible kidney transplantation. Standard treatment options for AMR due to blood group antibodies including immunoadsorption, lymphocyte depletion with anti-human T-lymphocyte globulins, intravenous methylprednisolone pulses and eculizumab limited tissue injury, however failed to sufficiently suppress blood group antibody production. After administration of daratumumab as a rescue therapy, blood group antibody titers decreased and remained at low levels without further immunoadsorption and allowed kidney graft function to recover.

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Spica, D., Junker, T., Dickenmann, M., Schaub, S., Steiger, J., Rüfli, T., … Hirt-Minkowski, P. (2019). Daratumumab for Treatment of Antibody-Mediated Rejection after ABO-Incompatible Kidney Transplantation. Case Reports in Nephrology and Dialysis, 9(3), 149–157. https://doi.org/10.1159/000503951

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