Background: The pathology scale for antibody-mediated rejection (AMR) was approved by the board of directors in 2013. The ISHLT AMR grading scale consists of pAMR 0, pAMR 1, and pAMR 2. The outcome of each grade of AMR rejection has not been fully assessed. We sought to review our patients with the various AMR grades and assess 3-year outcome.

Methods: Between 1994 and 2012 we assessed 1077 heart transplant patients and found 637 patients with first year pAMR 0 (n=528), pAMR 1 (n=91), and pAMR 2 (n=13). 3-year outcomes including survival, freedom from cardiac allograft vasculopathy (CAV) as defined by stenosis ≥ 30% and Non- Fatal Major Adverse Cardiac Events (NF-MACE: myocardial infarction, new congestive heart failure, percutaneous coronary intervention, implantable cardioverter defibrillator/pacemaker implant, stroke) were recorded.

Results: Compared to patients with pAMR 0, the patients with pAMR 1 and pAMR 2 had no significant difference in 3-year survival or freedom from CAV. However, pAMR 2 compared to pAMR 1 revealed a trend towards a lower freedom from 3-year NF-MACE.

Conclusion: Pathology AMR does not appear to have any significant difference in survival and CAV outcomes at 3 years, however, there appears to be a trend towards a greater risk in the development of NF-MACE for patients with pAMR 2. A larger number of patients and a longer period of follow up may be needed to further confirm these findings.

*P < 0.05 pAMR 2 compared to pAMR 1.

CITATION INFORMATION: Patel J, Kittleson M, Chang D, Aintablian T, Czer L, Trento A, Kobashigawa J. Outcome of the Various Pathology Grades of Antibody-Mediated Rejection After Heart Transplantation. Am J Transplant. 2016;16 (suppl 3).

« Back to 2016 American Transplant Congress