Poor Long-Term Renal Allograft Survival in Patients with Chronic Antibody-Mediated Rejection, Irrespective of Treatment—A Single Center Retrospective Study
| Autor: | Kaiyin Wu, Danilo Schmidt, Covadonga López del Moral, Bilgin Osmanodja, Nils Lachmann, Qiang Zhang, Fabian Halleck, Mira Choi, Friederike Bachmann, Simon Ronicke, Wiebke Duettmann, Marcel G. Naik, Eva Schrezenmeier, Birgit Rudolph, Klemens Budde |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Journal of Clinical Medicine, Vol 11, Iss 199, p 199 (2022) Journal of Clinical Medicine; Volume 11; Issue 1; Pages: 199 Journal of Clinical Medicine |
| ISSN: | 2077-0383 |
| Popis: | The Banff 2017 report permits the diagnosis of pure chronic antibody-mediated rejection (cAMR) in absence of microcirculation inflammation. We retrospectively investigated renal allograft function and long-term outcomes of 67 patients with cAMR, and compared patients who received antihumoral therapy (cAMR-AHT, n = 21) with patients without treatment (cAMRwo, n = 46). At baseline, the cAMR-AHT group had more concomitant T-cell-mediated rejection (9/46 (19.2%) vs. 10/21 (47.6%); p = 0.04), a higher g-lesion score (0.4 ± 0.5 versus 0.1 ± 0.3; p = 0.01) and a higher median eGFR decline in the six months prior to biopsy (6.6 vs. 3.0 mL/min; p = 0.04). The median eGFR decline six months after biopsy was comparable (2.6 vs. 4.9 mL/min, p = 0.61) between both groups, and three-year graft survival after biopsy was statistically lower in the cAMR-AHT group (35.0% vs. 61.0%, p = 0.03). Patients who received AHT had more infections (0.38 vs. 0.20 infections/patient; p = 0.04). Currently, antihumoral therapy is more often administered to patients with cAMR and rapidly deteriorating renal function or concomitant TCMR. However, long-term graft outcomes remain poor, despite treatment. |
| Databáze: | OpenAIRE |
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