{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T14:34:37Z","timestamp":1792074877242,"version":"4.4.0"},"reference-count":22,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2014,9,1]],"date-time":"2014-09-01T00:00:00Z","timestamp":1409529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The proteasome inhibitor bortezomib has been used with variable success in the treatment of <jats:styled-content style=\"fixed-case\">AMR<\/jats:styled-content> following heart transplant. There is limited experience with this agent as a pretransplant desensitizing therapy. We report a case of successful <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content> desensitization with a bortezomib\u2010based protocol prior to successful heart transplantation. A nine\u2010yr\u2010old boy with dilated cardiomyopathy, not initially sensitized to <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">cPRA<\/jats:styled-content> of zero), required three\u00a0days of <jats:styled-content style=\"fixed-case\">ECMO<\/jats:styled-content>, followed by implantation of a Heartmate II <jats:styled-content style=\"fixed-case\">LVAD<\/jats:styled-content>. Within six\u00a0wk, the patient developed <jats:italic>de novo<\/jats:italic> class I IgG and C1q complement\u2010fixing HLA antibodies with a <jats:styled-content style=\"fixed-case\">cPRA<\/jats:styled-content> of 100%. Two doses of <jats:styled-content style=\"fixed-case\">IVIG<\/jats:styled-content> (2\u00a0g\/kg) failed to reduce antibody levels, although two courses of a novel desensitization protocol consisting of rituximab (375\u00a0mg\/m<jats:sup>2<\/jats:sup>), bortezomib (1.3\u00a0mg\/m<jats:sup>2<\/jats:sup>\u00a0\u00d7\u00a05 doses), and plasmapheresis reduced his <jats:styled-content style=\"fixed-case\">cPRA<\/jats:styled-content> to 0% and 87% by the C1q and IgG assays, respectively. He underwent heart transplantation nearly two\u00a0months later. The patient is now &gt;one\u00a0yr post\u2010transplant, is free of both <jats:styled-content style=\"fixed-case\">AMR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">ACR<\/jats:styled-content>, and has no detectable donor\u2010specific antibodies by IgG or C1q. Proteasome inhibition with bortezomib and plasmapheresis may be an effective therapy for <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content> desensitization pretransplant.<\/jats:p>","DOI":"10.1111\/petr.12347","type":"journal-article","created":{"date-parts":[[2014,9,1]],"date-time":"2014-09-01T05:25:23Z","timestamp":1409549123000},"source":"Crossref","is-referenced-by-count":18,"title":["HLA desensitization with bortezomib in a highly sensitized pediatric patient"],"prefix":"10.1111","volume":"18","author":[{"given":"Lindsay J.","family":"May","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Stanford University School of Medicine Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Yeh","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Stanford University School of Medicine Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuhide","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Stanford University Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dolly B.","family":"Tyan","sequence":"additional","affiliation":[{"name":"Department of Pathology Stanford University School of Medicine Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Stanford University School of Medicine Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth D.","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Stanford University School of Medicine Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Bernstein","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Stanford University School of Medicine Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David N.","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Stanford University School of Medicine Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth A.","family":"Hollander","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Stanford University School of Medicine Palo Alto CA 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