我们报道了一例人CD38单克隆抗体达雷木单抗治疗的抗体介导的排斥反应病例,该病例是一名58岁的女性患者,该患者因常染色体显性遗传多囊肾疾病而患有终末期肾病,接受了ABO和人类白细胞抗原抗体不相容的活体供者肾移植。患者在移植的第一周内经历了严重的抗体介导的排斥反应。血型抗体选择性免疫吸附与四剂达雷妥单抗(每剂1800mg皮下注射)联合使用导致ABO-更有趣的是供体特异性人类白细胞抗原抗体反应性持续降低,并导致临床和组织病理学缓解,移植物功能完全恢复,一直保持稳定,直到移植后第212天。这种情况说明了在抗体介导的排斥中靶向CD38的潜力。
We report a case of antibody-mediated rejection treated with the human CD38 monoclonal antibody daratumumab in a 58-year-old female patient with end-stage kidney disease due to autosomal dominant polycystic kidney disease who received an ABO- and human leukocyte antigen antibody-incompatible living donor kidney transplant. The patient experienced an episode of severe antibody-mediated rejection within the first week of transplantation. Blood-group-antibody selective immunoadsorption in combination with administration of four doses of daratumumab (each 1800 mg s.c.) led to a persistent decrease of ABO- and more interestingly donor-specific human leukocyte antigen antibody reactivity and resulted in clinical and histopathological remission with full recovery of graft function, which has remained stable until post-transplant day 212. This case illustrates the potential of targeting CD38 in antibody-mediated rejection.