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Case Reports
. 2025 Aug;29(5):e70116.
doi: 10.1111/petr.70116.

Daratumumab for Treatment of Acute Antibody-Mediated Rejection in a Pediatric Kidney Transplant Recipient

Hailey Connolly  1 , Ally Watson  1 , Michael Wynd  2 , Kenneth Lieberman  1 , Melissa Chaung  2 , Michael J Goldstein  2 , Guillermo Hidalgo  3 , Ibrahim Batal  4 , Marlene Amoruso  2 , Namrata G Jain  1
Affiliations
Case Reports

Daratumumab for Treatment of Acute Antibody-Mediated Rejection in a Pediatric Kidney Transplant Recipient

Hailey Connolly et al. Pediatr Transplant. 2025 Aug.

Abstract

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.

Keywords: antibody‐mediated rejection; daratumumab; kidney transplantation; pediatrics.

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References

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