20.500.12556/RUL-186998 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 Članek v reviji 2026-09-08 09:25:44 2026-09-08 09:25:49 2026-10-06 04:26:20 0000-00-00 00:00:00 2026 0 0 5 str. iss. 9, art. 101473 Vol. 8 2026 0000-00-00 Zaloznikova Objavljeno NiDoloceno 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 A372F2B835D9DA6750AE3864349BB9F2 7da1db21501f916ae5fb80bf87bba9c2d788a5c99a764eb19bdb534c0a05774b 3d003794-c0a1-11f1-8bc5-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=249886 https://www.sciencedirect.com/science/article/pii/S2590059526002359 1 812876b8-ab56-11f1-8bc5-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=246410 Medicinska fakulteta 0 0 0