دورية أكاديمية
Reducing Donor-specific Antibody During Acute Rejection Diminishes Long-term Renal Allograft Loss: Comparison of Early and Late Rejection.
| العنوان: | Reducing Donor-specific Antibody During Acute Rejection Diminishes Long-term Renal Allograft Loss: Comparison of Early and Late Rejection. |
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| المؤلفون: | Lichvar AB; Department of Pharmacy Practice and Surgery, University of Illinois at Chicago, Chicago, IL., Tremblay S; Department of Surgery, Division of Transplantation, University of Cincinnati, Cincinnati, OH.; Department of Environmental Health, Division of Epidemiology, University of Cincinnati, Cincinnati, OH., Leino AD; Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, OH., Shields AR; Department of Surgery, Division of Transplantation, University of Cincinnati, Cincinnati, OH.; The Christ Hospital, Cincinnati, OH., Cardi MA; The Christ Hospital, Cincinnati, OH., Abu Jawdeh BG; Department of Internal Medicine, Division of Nephrology, University of Cincinnati, Cincinnati, OH., Govil A; Department of Internal Medicine, Division of Nephrology, University of Cincinnati, Cincinnati, OH., Kremer J; The Christ Hospital, Cincinnati, OH., Cuffy M; Department of Surgery, Division of Transplantation, University of Cincinnati, Cincinnati, OH., Paterno F; Division of Liver Transplantation and Hepatobiliary Surgery, Rutgers New Jersey Medical School, Newark, NJ., Diwan T; Department of Surgery, Division of Transplantation, University of Cincinnati, Cincinnati, OH., Brailey P; Transplant Immunology Division, Hoxworth Blood Center, University of Cincinnati, Cincinnati, OH., Girnita A; Transplant Immunology Division, Hoxworth Blood Center, University of Cincinnati, Cincinnati, OH., Alloway RR; Department of Internal Medicine, Division of Nephrology, University of Cincinnati, Cincinnati, OH., Woodle ES; Department of Surgery, Division of Transplantation, University of Cincinnati, Cincinnati, OH. |
| المصدر: | Transplantation [Transplantation] 2020 Nov; Vol. 104 (11), pp. 2403-2414. |
| نوع المنشور: | Comparative Study; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0132144 Publication Model: Print Cited Medium: Internet ISSN: 1534-6080 (Electronic) Linking ISSN: 00411337 NLM ISO Abbreviation: Transplantation Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Hagerstown, MD : Lippincott Williams & Wilkins Original Publication: Baltimore, Williams & Wilkins. |
| مواضيع طبية MeSH: | Plasmapheresis*/adverse effects, Bortezomib/*therapeutic use , Graft Rejection/*therapy , Graft Survival/*drug effects , Immunosuppressive Agents/*therapeutic use , Isoantibodies/*blood , Kidney Transplantation/*adverse effects , Proteasome Inhibitors/*therapeutic use, Adult ; Biomarkers/blood ; Bortezomib/adverse effects ; Down-Regulation ; Female ; Graft Rejection/blood ; Graft Rejection/diagnosis ; Graft Rejection/immunology ; Humans ; Immunosuppressive Agents/adverse effects ; Male ; Middle Aged ; Phenotype ; Proteasome Inhibitors/adverse effects ; Retrospective Studies ; Time Factors ; Treatment Outcome |
| مستخلص: | Background: Reduction in donor-specific antibody (DSA) has been associated with improved renal allograft survival after antibody-mediated rejection (AMR). These observations have not been separately analyzed for early and late AMR and mixed acute rejection (MAR). The purpose of this study was to evaluate long-term responses to proteasome inhibitor-based therapy for 4 rejection phenotypes and to determine factors that predict allograft survival. Methods: Retrospective cohort study evaluating renal transplant recipients with first AMR episodes treated with proteasome inhibitor-based therapy from January 2005 to July 2015. Results: A total of 108 patients were included in the analysis. Immunodominant DSA reduction at 14 days differed significantly (early AMR 79.6%, early MAR 54.7%, late AMR 23.4%, late MAR 21.1%, P < 0.001). Death-censored graft survival (DCGS) differed at 3 years postrejection (early AMR 88.3% versus early MAR 77.8% versus late AMR 56.7% versus late MAR 54.9%, P = 0.02). Multivariate analysis revealed that immunodominant DSA reduction > 50% at 14 days was associated with improved DCGS (odds ratio, 0.12, 95% CI, 0.02-0.52, P = 0.01). Conclusions: In summary, significant differences exist across rejection phenotypes with respect to histological and DSA responses. The data suggest that DSA reduction may be associated with improved DCGS in both early and late AMR. |
| التعليقات: | Comment in: Transplantation. 2020 Nov;104(11):2260-2261. (PMID: 32000257) |
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| المشرفين على المادة: | 0 (Biomarkers) 0 (Immunosuppressive Agents) 0 (Isoantibodies) 0 (Proteasome Inhibitors) 69G8BD63PP (Bortezomib) |
| تواريخ الأحداث: | Date Created: 20200131 Date Completed: 20210209 Latest Revision: 20210209 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1097/TP.0000000000003145 |
| PMID: | 32000256 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1534-6080 |
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| DOI: | 10.1097/TP.0000000000003145 |