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Updated: May 8, 2026

Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Daratumumab for Treatment of Acute Antibody-Mediated Rejection in a Pediatric Kidney Transplant Recipient
Hailey Connolly1, Ally Watson1, Michael Wynd2
1Division of Pediatric Nephrology, Department of Pediatrics, Joseph M. Sanzari Children's Hospital at Hackensack University Medical Center, Hackensack, New Jersey, USA.
Background:
Daratumumab, an anti-CD38 monoclonal antibody, has shown efficacy as a potential treatment for antibody-mediated rejection (ABMR) following kidney transplantation in adults.
Methods:
We present a case demonstrating the use of daratumumab for the management of ABMR in a pediatric kidney transplant recipient.
Results:
The patient underwent a living-unrelated donor renal transplant with a post-transplant course complicated by active ABMR. The patient received a total of four daratumumab infusions with a subsequent decrease in serum creatinine, serum donor-specific antibody levels, and donor-derived cell-free DNA (dd-cfDNA), which remained low 1 year following treatment.
Conclusions:
Daratumumab may be a promising treatment consideration for the management of ABMR in pediatric patients following renal transplantation, though further research is needed to better understand its efficacy and side effects. DD-cfDNA may also be a promising tool to monitor treatment response in conjunction with more traditional methods.
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