Lowering donor-specific antibodies in sensitized kidney transplant patients

Determinants of donor-specific B cell tolerance in kidney transplantation in sensitized recipients

NIH-funded research Duke University · NIH-11528915

This project works to reduce harmful donor-specific antibodies in people who are sensitized and need a kidney transplant so their new organ lasts longer.

Quick facts

Grant typeNIH-funded research
Study typeNIH-funded research
Funding institutionDuke University NIH-funded
Lab location1 site (Durham, United States)
Project IDNIH-11528915 on NIH RePORTER

What this research studies

Researchers are combining drugs that target antibody-producing cells (like the proteasome inhibitor carfilzomib) with immune co-stimulation blockade (belatacept) and cytolytic induction to remove preformed antibodies before transplantation. These approaches showed reduced donor-specific antibodies, fewer early antibody-mediated rejections, and longer graft survival in nonhuman primates. However, the treatments did not fully prevent later antibody-mediated rejection and were linked to complications such as viral reactivation, so the team is studying how donor-specific B cell tolerance is formed and lost. The goal is to design safer, longer-lasting desensitization strategies that prevent rejection without causing unacceptable side effects.

Who could benefit from this research

Good fit: Ideal candidates are people who are sensitized with preformed HLA antibodies (from prior transfusion, pregnancy, or transplant) and who are candidates for kidney transplantation.

Not a fit: Patients without HLA sensitization or those who cannot tolerate intensified immunosuppression (for example because of active infections) are unlikely to benefit from these approaches.

Why it matters

Potential benefit: If successful, this work could increase transplant opportunities for sensitized patients and improve graft survival by preventing antibody-mediated rejection.

How similar studies have performed: Similar drug combinations reduced antibodies and prolonged graft survival in nonhuman primates, but human experience is limited and late antibody-mediated rejection and infection risk remain concerns.

Where this research is happening

Durham, United States

Researchers

About this research

  1. This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
  2. Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
  3. For full project details, budget, and progress reports, visit the official NIH RePORTER page below.
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.