Abstract: SA-PO1075
Effect of Different Treatment Regimens on Kidney Graft Function and Mortality in Patients with a Diagnosis of Antibody-Mediated Rejection
Session Information
- Transplantation: Clinical - II
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Díaz González, Laura Elizabeth, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
- Hernandez Pugh, Ana Cristina, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
- Cerrillos, Jose Ignacio, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
- Andrade-Sierra, Jorge, Universidad de Guadalajara Centro Universitario de Ciencias de la Salud, Guadalajara, Jalisco, Mexico
- Rojas-Campos, Enrique, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
- Evangelista-Carrillo, Luis Alberto, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
- Jalomo martínez, Basilio, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
- Medina Perez, Miguel, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
Background
The optimal treatment for Antibody mediated rejection (AMR) remains uncertain, and its presence causes up to 60% of kidney grafts loss.
Methods
A retrospective cohort from May-2016 to June 2022, that included 176 patients ≥18 years old, hospitalized with graft dysfunction and histopathological diagnosis of AMR to receive treatment. Were categorized into 3 groups; 1. Plasmapheresis (PF) + Intravenous immunoglobulin (IVIG), 2. IVIG + Rituximab (RTX) 3. Steroids and immunosuppression treatment optimization.
Results
On average, 63% of patients were men, and a majority were transplanted with a living donor kidney (89%), showing a median of age 32 ± 9; baseline serum creatinine (CrS) was 1.15 and during the rejection, 2.75 mg/dL; timing of biopsy 6 ± 5 years; C4d positive (68%) comparing groups of treatments there were no significant difference by CrS at the end of the follow up, episodes of infections was 27%, 20% and 10% (P=0.61), mortality was 6.8%, 2.5% and 5.8% each group (P=0.47).
Conclusion
There was no significant difference in graft function and mortality between treatment groups, but in a logistic regression analysis, predictive variables of poor graft prognosis were: CrS greater than 2.5 mg/dl at the beginning of treatment, using steroids and immunosuppression optimization treatment; greater chronicity and being younger at the time of diagnosis.