Targeting HLA Antibodies with belatacept and a proteasome inhibitor in heart transplantation

The primary objective of this study is to define functionally relevant, mechanistically driven biomarkers that predict and monitor response to a synergistic strategy targeting HLA antibodies with belatacept and a proteasome inhibitor. This will be accomplished by performing i) detailed immunophenotyping, ii) HLA antibody characterization, and iii) intragraft molecular assessment using gene expression profiling. The secondary objective is to use these findings to develop novel, precision-based therapeutic paradigms which can ultimately be tailored to the patient's underlying immunophenotype.