| Title: | Subcutaneous daratumumab in recurrent posttransplant focal segmental glomerulosclerosis : a report of 2 cases |
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| Authors: | ID Aleš Rigler, Andreja (Author)
ID Belčič Mikič, Tanja (Author)
ID Bošnjak, Matic (Author)
ID Arnol, Miha (Author) |
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| Files: |  PDF - Presentation file, download (3,08 MB)
MD5: 9BB9B54600919A0D49687B80584470AF
 URL - Source URL, visit https://www.kidneymedicinejournal.org/article/S2590-0595(26)00235-9/fulltext
URL - Source URL, visit https://www.sciencedirect.com/science/article/pii/S2590059526002359
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| Language: | English |
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| Typology: | 1.03 - Other scientific articles |
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| Organization: |  UKC LJ - Ljubljana University Medical Centre
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| Abstract: | 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. |
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| Keywords: | kidney transplantation, primary focal segmental glomerulosclerosis, daratumumab |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Year of publishing: | 2026 |
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| Number of pages: | str. 1-5 |
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| Numbering: | Vol. 8, issue 9 |
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| PID: | 20.500.12556/DiRROS-32427  |
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| UDC: | 616.61 |
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| ISSN on article: | 2590-0595 |
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| DOI: | 10.1016/j.xkme.2026.101473 |
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| COBISS.SI-ID: | 288124675 |
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| Note: | Nasl. z nasl. zaslona;
Opis vira z dne 19. 8. 2026;
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| Pub. date in DiRROS: | 10.09.2026 |
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| Views: | 33 |
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| Downloads: | 26 |
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