Clinical Research Directory

Inclusion Criteria: 1. Voluntary written informed consent. 2. Age ≥18 years. 3. Kidney transplant (living or deceased donor) ≥180 days prior. 4. eGFR ≥30 mL/min/1.73 m² (CKD-EPI 2021). 5. Currently on stable triple immunosuppression (CNI + MMF + steroid) for ≥4 weeks, no severe related adverse effects. 6. Positive HLA Class I and/or Class II donor-specific antibodies (DSA). 7. Transplant kidney biopsy meeting Banff 2022 criteria for chronic active antibody-mediated rejection (caABMR). 8. TPMT/NUDT15 genotyping: non-homozygous mutant (normal or intermediate metabolizer). Exclusion Criteria: 1. Participating in another clinical trial. 2. Age \<18 years. 3. Pregnant, breastfeeding, or inadequate contraception in females. 4. ABO-incompatible transplant. 5. TPMT/NUDT15 homozygous mutant genotype. 6. Biopsy shows any of: T-cell mediated rejection (TCMR), new/recurrent severe thrombotic microangiopathy, or polyomavirus nephropathy. 7. Received anti-rejection therapy in prior 3 months. 8. Received other immunomodulatory monoclonal/polyclonal antibodies (anti-CD20, bortezomib, anti-C5, anti-IL-6/IL-6R) in prior 3 months. 9. Total bilirubin \>2×ULN or ALT/AST \>2.5×ULN. 10. Hemoglobin \<8 g/dL. 11. Platelets \<100×10\^9/L. 12. WBC \<3×10\^9/L or neutrophils \<1.5×10\^9/L. 13. Hypogammaglobulinemia: IgG \<400 mg/dL. 14. Active bacterial, viral, or fungal infection. 15. Active malignancy requiring intensified immunosuppression. 16. Latent or active tuberculosis. 17. Live vaccine within 6 weeks of screening. 18. History of alcohol or illicit drug abuse. 19. Severe medical or psychiatric illness likely to impair study participation. 20. Active hepatitis B. 21. Known hypersensitivity to CD38 mAb, azathioprine, or study drug components, or severe drug allergy history.