In:
Therapeutic Apheresis and Dialysis, Wiley, Vol. 20, No. 3 ( 2016-06), p. 240-245
Abstract:
Antibody‐mediated rejection (AMR) is a major cause of kidney graft failure. We aimed to analyze treatment and outcome of AMR in a national cohort of 75 biopsy‐proven acute (43 patients, 57%) or chronic active (32 patients, 43%) AMR episodes between 2000 and 2015. The mean patients' age was 46 ± 16 years, the majority was treated with plasma exchange, 4% received immunoadsorption and 7% received both. The majority received pulse methylprednisolone and low‐dose CMV hyperimmune globulin, 20% received bortezomib and 13% rituximab. Concomitant infection was treated in 40% of patients. The immediate treatment outcome was successful in 91%, the 1‐ and 3‐year graft survival rates were 71% and 57%, while 3‐year patient survival was 97%. Chronic active AMR was associated with worse graft survival than acute AMR (log rank P = 0.06). To conclude, intensive treatment with apheresis and additional immunosuppression was effective in reversing AMR, but long‐term graft survival remains markedly decreased, especially in chronic active AMR.
Type of Medium:
Online Resource
ISSN:
1744-9979
,
1744-9987
DOI:
10.1111/tap.2016.20.issue-3
DOI:
10.1111/1744-9987.12430
Language:
English
Publisher:
Wiley
Publication Date:
2016
detail.hit.zdb_id:
2010864-3
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