ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Novel Treatment of Acute Antibody-Mediated Rejection in a Nonhuman Primate Model of Kidney Allotransplantation

R. Schmitz1, Z. W. Fitch1, A. Y. Choi1, M. Manook1, J. Yoon1, J. D. Lambris2, J. Kwun1, S. J. Knechtle1

1Department of Surgery, Duke University Medical Center, Durham, NC, 2Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA

Meeting: 2020 American Transplant Congress

Abstract number: 25

Keywords: Alloantibodies, B cells, Co-stimulation, T helper cells

Session Information

Session Name: Kidney Acute Antibody Mediated Rejection

Session Type: Oral Abstract Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:45pm

 Presentation Time: 4:27pm-4:39pm

Location: Virtual

*Purpose: One third of sensitized, HLA-incompatible transplant recipients experience acute antibody mediated rejection (AMR) with limited treatment options. We tested a novel treatment strategy for AMR consisting of complement inhibition, proteasome inhibition and costimulation blockade in a nonhuman primate model.

*Methods: Three (3) rhesus macaques were sensitized to maximally MHC mismatched donors by two sequential skin transplants. Primates subsequently received kidney allografts from their skin donors without prior desensitization. All primates were maintained on tacrolimus, MMF and steroids immunosuppression. Primates were monitored postoperatively for signs of acute AMR, which was defined as worsening kidney function resistant to high dose steroid rescue therapy and a rise in serum donor-specific antibody (DSA) levels. Our AMR treatment consisted of a combination of the C3 complement inhibitor Compstatin for 1 week together with carfilzomib and belatacept for 4 weeks.

*Results: The included primates began treatment on days 19, 40 and 48, respectively. The combination of Compstatin, carfilzomib and belatacept was tolerated well and we did not observe any treatment-related toxicity. After initiation of treatment, we observed a reduction of class I and class II DSA in all primates (Figure 1A). Additionally, we observed reduction of peripheral blood plasma cells, defined as CD20–CD19+CD38+ cells, by flow cytometry (Figure 1B), as well as peripheral blood T follicular helper cells (Figure 1C). Most importantly, primates experienced improvement of kidney function as evidenced by reduced serum creatinine and BUN as well as increased urine output. Our treatment extended the graft survival by up to 2 months.

*Conclusions: The combination of Compstatin, carfilzomib and belatacept was able to control the humoral immune response seen during acute AMR in a sensitized nonhuman primate model. This was associated with improved graft function and prolongation of graft survival.

 border=

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Schmitz R, Fitch ZW, Choi AY, Manook M, Yoon J, Lambris JD, Kwun J, Knechtle SJ. Novel Treatment of Acute Antibody-Mediated Rejection in a Nonhuman Primate Model of Kidney Allotransplantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/novel-treatment-of-acute-antibody-mediated-rejection-in-a-nonhuman-primate-model-of-kidney-allotransplantation/. Accessed May 11, 2025.

« Back to 2020 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences