20.500.12556/DiRROS-32427 Subcutaneous daratumumab in recurrent posttransplant focal segmental glomerulosclerosis a report of 2 cases Recurrent primary focal segmental glomerulosclerosis (FSGS) after kidney transplantation requires prolonged treatment, often with unsatisfactory results. We report 2 cases of FSGS recurrence that achieved remission with subcutaneous daratumumab and propose novel mechanisms of its action that demonstrate efficacy in this disease. The first patient was a 51-year-old woman who experienced early FSGS recurrence 1 month after transplantation. With regular biweekly plasma exchange, her daily proteinuria was 1-1.5 g, and the estimated glomerular filtration rate was 43 mL/min/1.73 m2. Although 2 doses of rituximab depleted CD19/20 B lymphocytes, they were ineffective in reducing proteinuria, leading to the reintroduction of plasma exchange. Based on histological persistence of FSGS at the 1-year surveillance biopsy, subcutaneous daratumumab treatment was initiated, which led to a rapid decrease in proteinuria and disease remission. The second patient was a 25-year-old woman with a second relapse of FSGS 7 years after transplantation, which was immune adsorption dependent as rituximab was ineffective in inducing remission. A kidney biopsy performed 2 years later showed persistence of FSGS as well as chronic active antibody-mediated rejection. Daratumumab treatment was initiated using the chronic active antibody-mediated rejection treatment protocol. With this treatment, daily proteinuria decreased from 6 g to 0.3-0.5 g, and immune adsorption was discontinued. In conclusion, daratumumab shows promise in controlling recurrent FSGS in selected kidney transplant recipients with potential mechanisms beyond plasma and natural killer cells. kidney transplantation primary focal segmental glomerulosclerosis daratumumab true false true Angleški jezik Ni določen Neznano 2026-09-10 14:32:22 2026-09-10 14:32:24 2026-09-11 03:36:49 0000-00-00 00:00:00 2026 0 0 Nasl. z nasl. zaslona; Opis vira z dne 19. 8. 2026; str. 1-5 issue 9 Vol. 8 2026 0000-00-00 Zaloznikova Objavljeno apc 0000-00-00 0000-00-00 0000-00-00 616.61 2590-0595 10.1016/j.xkme.2026.101473 288124675 RAZ_Ales_Rigler_Andreja_2026.pdf RAZ_Ales_Rigler_Andreja_2026.pdf 1 9BB9B54600919A0D49687B80584470AF 72540046f7ff33eeff2e3ebe7f469e6e789941e2acf11d5e6848021140e88c9e 0cd6a228-ad03-11f1-92ee-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=50746 https://www.kidneymedicinejournal.org/article/S2590-0595(26)00235-9/fulltext 1 ee9b3587-ad02-11f1-92ee-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=50744 https://www.sciencedirect.com/science/article/pii/S2590059526002359 1 eed94128-ad02-11f1-92ee-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=50745 Univerzitetni klinični center Ljubljana 0 0 0