Table 2.
Immunosuppression, Timing of AMR Treatment and Bortezomib Protocol, and Indication for Bortezomib Protocol
| Pt # | Induction IS | Maintenance IS at time of Bortezomib | Time Post-Tx AMR Treatment Initiated | Time Post-Tx of Previous AMR Treatments | Time Treated for AMR prior to Bortezomib Protocol | Time Post-Tx of Bortezomib Protocol | Indication for Bortezomib Protocol | Rounds of Bortezomib Protocol |
|---|---|---|---|---|---|---|---|---|
|
| ||||||||
| 1 | ATG | FK MMF Steroid |
0m | MP (0m) IVIG (0m) ATG (0m) |
1m | 1m | ↑ DSA ATN→AMR |
1 |
| 2 | Basiliximab | FK MMF Steroid |
13m | MP (13m) IVIG (13m, 15m) |
3m | 16m | ↑ DSA ACR→AMR |
3 |
| 3 | Daclizumab | FK Leflunomide Steroid |
65m | MP (65m) Rituximab (65m) IVIG (65m–70m) |
5m | 70m | ↓ eGFR Persistent DSA Persistent AMR |
2 |
| 4 | Daclizumab | FK MMF Steroid |
134m | MP (134m), Rituximab (134m), IVIG (134m, 138m) |
6m | 140m | ↑ DSA Persistent AMR |
2 |
| 5 | Daclizumab | FK MMF Steroid |
138m | MP(138m), Rituximab (138m) IVIG (138m & 142m) |
7m | 145m | ↑ DSA Persistent AMR |
2 |
| 6 | ATG | FK MMF Steroid |
0m | IVIG (0m–15m) PP (0m–15m) Rituximab (1m) MP (8m) ATG (8m) |
19m | 19m | ↓ eGFR ↑ DSA AMR Recurrence |
2 |
| 7 | Daclizumab | CYA MMF Steroid |
45m | MP (45m), Rituximab (45m) IVIG (45m, 51m, 63m–65m) PP (63m–65m) |
20m | 65m | ↑ DSA Persistent AMR |
2 |
Pt patient, IS immunosuppression, FK tacrolimus, MMF mycophenolate mofetil, y year, m months, MP methylprednisolone pulse, IVIG intravenous immunoglobulin, PP plasmapheresis, ATG antithymocyte globulin, DSA donor specific antibody, eGFR estimated glomerular filtration rate, ATN acute tubular necrosis, AMR antibody-mediated rejection, ACR acute cellular rejection. Ranges reflect multiple doses/treatments during a given time period.