{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T17:51:37Z","timestamp":1792259497150,"version":"4.4.0"},"reference-count":27,"publisher":"The Korean Society of Nephrology","issue":"2","license":[{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["krcp-ksn.org"],"crossmark-restriction":true},"short-container-title":["Kidney Res Clin Pract"],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:p>Background: Sensitization acts as an immunological barrier to successful kidney transplantation (KT). We aim to investigate the efficacy and safety of bortezomib-based desensitization (BOZ-DSZ) in both highly sensitized living donor KT (LDKT) and deceased donor KT (DDKT). Methods: We applied BOZ-DSZ to 20 highly sensitized patients\u201414 LDKT and six DDKT candidates\u2014and analyzed the change in anti-human leukocyte antigen (HLA) antibody, the success rate of transplantation, and posttransplant outcomes including biopsy-proven allograft rejection (BPAR) rate, infectious complication, and allograft survival. Results: Among 14 LDKT candidates, the peak mean fluorescence intensity (MFI) level of donor-specific anti-HLA antibody (HLA-DSA) decreased in 10 patients (p &lt; 0.05), and the success rate of KT was 92.9% (13 of 14). Incidence of BPAR within the first posttransplant year was 53.8% (7 of 13), and all such cases were rescued by antirejection treatment. One case resulted in mortality due to pneumonia, and there was one allograft failure during the follow-up of 34 months (range, 6\u2013129 months). Among the six DDKT candidates, the peak MFI level of HLA-DSA showed a significant decrease after DSZ in five patients (p = 0.098), and the success rate of KT was 50.0% (3 of 6). One BPAR case (33.3%) occurred within the first posttransplant year and was successfully treated. There was one case of Cytomegalovirus viremia, and there was no allograft failure during the 36-month follow-up (range, 17\u201342 months).Conclusion BOZ-DSZ is effective and safe in terms of successful DSZ, infectious complications, and allograft outcomes for both highly sensitized LDKT and DDKT candidates.<\/jats:p>","DOI":"10.23876\/j.krcp.24.077","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T03:00:41Z","timestamp":1739934041000},"page":"253-262","update-policy":"https:\/\/doi.org\/10.23876\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinical outcomes of bortezomib-based desensitization in highly sensitized living and deceased donor kidney 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