Effect of desensitization on class I & II HLA antibodies.
(a) Mean MFI for all class I HLA antibodies before and after desensitization in each case (n=4). Mean MFI was calculated as the average of the MFIs of all antibodies against HLA class I. Diluted serum was used when MFI was >15,000 to keep values within the linear portion of the curve. HLA antibodies were reassessed at >1 month after PI therapy except in case 3 (n=3 days due to anticipated transplant). (b) Mean MFI for all class II HLA antibodies before and after desensitization in each case. Case 1 did not have class II antibodies (N/A). (c) Heatmap illustrating the response of class I HLA antibodies to desensitization with sequential cycles of treatment (case 3). Cycle 1: bortezomib/belatacept (no plasmapheresis); Cycle 2: bortezomib/plasmapheresis, belatacept continued; Cycle 3: carfilzomib/plasmapheresis, belatacept continued. (d) Heatmap illustrating the response of class II HLA antibodies to desensitization with sequential cycles of treatment as above (case 3; results shown in 1:8 dilution). MFI, mean fluorescence intensity.