More recently, we reported on the treatment with Bortezomib, a proteasome inhibitor, in a patient diagnosed with advanced chronic active C4d-positive AMR (Schwaiger, E et al. 2011). In this patient, a single cycle of Bortezomib led to an impressive decrease in DSA levels and a complete disappearance of capillary C4d deposits in a follow-up biopsy. Also a remarkable observation was the stable decrease in proteinuria. As expected, advanced chronic lesions (severe transplant glomerulopathy) in this patient remained unchanged. Nevertheless, 16 months after treatment, kidney function stabilized and the protein/creatinine ratio was still half of the initial value of 4,000 mg/g.