Introduction: Histological findings that meet the criteria for Borderline rejection (BR) as defined by the Banff Classification are frequently seen. The clinical significance of a BR is unclear and currently there is no consensus that there is a benefit to treatment of BR. We compared the outcomes of BR that were treated with those who were not.

Methods: We identified all patients who were found to have a BR from January 2014 through December 2014 on a for cause biopsy at Columbia University Medical Center. Protocol biopsies in high risk patients (DSA positive) and ABO incompatible patients were excluded. We reviewed the demographics of patients, whether they were treated and its impact on subsequent function.

Results: We identified 41 patients with an initial BR with a mean age 48.1± 23.4 years, 48.8% female. Mean Serum Cr at the time of biopsy was 2.4±2.0 mg/dL. Twenty seven (65%) of patients were treated while the rest were followed closely with no acute interventions at the discretion of the treating physician. Treated and untreated patients had similar renal function at the time of the biopsy and similar renal function, 4 weeks and 6 months following the index biopsy. (Table 1)

Conclusion: The treatment of borderline rejection in our single center cohort did not appear to have a beneficial impact on the short term allograft function compared to patients who did not receive additional immunosuppressive therapy. Our results are likely confounded by physician perception of the patient's immunological risk and need to be confirmed in a larger prospective study.

CITATION INFORMATION: Mustafa R, Al Azzi Y, Crew J, Dube G, Morris H, Chiles M, Chang J, Fernandez H, Cohen D, Batal I, Campenot E, Mohan S. The Impact of Treating Borderline Cellular Rejections. Am J Transplant. 2016;16 (suppl 3).

« Back to 2016 American Transplant Congress