TABLE 1.
Case details
| Case 1 | Case 2 | Case 3 | Case 4 | |
|---|---|---|---|---|
| Age at bortezomib treatment | 14 mo | 21 mo | 13 mo | 5 yr |
| Age at transplantation (mo) | 10 | 19 | 13 | 26 |
| Interval to AMR | 4 mo | 2 mo | 7 d | 35 mo |
| Pretransplant DX | Myocarditis | HLHS | HLHS | HLHS |
| Previous surgery | No | Stage I and II Norwood | Stage I and II Norwood | Stage I and II Norwood |
| Previous mechanical support | ECMO, Berlin Heart | ECMO | No | No |
| cPRA before bortezomib (%) | 98 | 27 | 91 | 53 |
| Previous treatment | IVIg, PP, rituximab | PP | PP, IVIg | PP, IVIg×8 |
| Class I MFI before bortezomib, total (iDSA) | 5414 (2970) | 15,249 (11,249) | 25,200 (19,200) | 2524 (1959)a |
| Class I MFI after bortezomib, total (iDSA) | 359 (347)a | 6801 (4990) | 805 (600) | 152 (84) |
| Class I percent change MFI, total (iDSA) | 93 (88) | 55 (56) | 97 (97) | 81 (90) |
| Class II MFI pre, total (iDSA) | 25,653 (11,300) | 11,672 (8,9420) | Not performed | 5396 (4726) |
| Class II MRI post, total (iDSA) | 4246 (3306) | 1980 (1873) | Not performed | 274 (117) |
| Class II MFI percent change, total (iDSA) | 83 (71) | 83 (79) | Not performed | 95 (85) |
a
Initial decline after institution of ECMO and plasmapheresis from 2524 (1959) to 805 (805).
AMR, antibody mediated rejection; HLHS, hypoplastic left heart syndrome; ECMO, extracorporeal membrane oxygenator; IVIg, intravenous immunoglobulin; PP, plasmapheresis; cPRA, calculated panel reactive antibody; iDSA, immunodominant donor specific antibody; MFI, mean fluorescent intensity.