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Updated: Jan 15, 2026
Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
CD38-targeted therapy with Daratumumab in clinical lung transplantation: A single-center experience
Caroline Hillebrand1,2, Giuseppe Maggioni3, Sophia Auner1,2
1Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria.
Background:
Antibody-mediated rejection remains a major threat to long-term graft function after lung transplantation. Current therapies aim to eliminate circulating antibodies and suppress B-cell-activity but often fail to reduce donor-specific antibodies. Daratumumab, a monoclonal antibody targeting CD38, has shown potential in depleting antibody-producing plasma cells. This study investigates the clinical application of daratumumab in lung transplant recipients.
Methods:
We performed a retrospective single-center study including all lung transplant recipients treated with subcutaneous daratumumab for antibody-mediated rejection A total of 14 patients with newly developed donor-specific antibodies and clinical antibody-mediated rejection were analyzed.
Results:
In all patients with AMR, antibodies directed against human leukocyte antigen class I decreased to less than 25-50% of baseline levels within 12 weeks. Antibodies against class II also declined in 5 patients. Eleven patients survived the initial AMR episode. Chronic lung allograft dysfunction was already present in several patients before the AMR episode, while others developed CLAD during follow-up. The treatment was generally well tolerated with the most common side effects being leukopenia, hypogammaglobulinemia and infections.
Conclusions:
CD38-targeted therapy with daratumumab may represent a promising addition to the antibody mediated rejection treatment panel.
