Effect of Antibody Mediated Rejection on Long-Term Renal Allograft Function

M. John, A. Smith, I. Dortonne, A. Paramesh, M. Killackey, B. Lee, R. Zhang, J. Buell.

Transplant Institute, Tulane University, New Orleans, LA.

Meeting: 2015 American Transplant Congress

Abstract number: A134

Keywords: Adverse effects, African-American, Rejection

Session Information

Session Name: Poster Session A: Kidney Antibody Mediated Rejection

Session Type: Poster Session

Date: Saturday, May 2, 2015

Session Time: 5:30pm-7:30pm

Presentation Time: 5:30pm-7:30pm

Location: Exhibit Hall E

Historically we had poor understanding of chronic rejection attributing it to hypertension and non-compliance. However in the last decade we have begun to understand the impact of antibody mediated rejection on chronic rejection. This study examines the incidence and effect of antibody-mediated rejection (AMR) on chronic rejection and allograft function.

Methods: Retrospective analysis of 719 renal transplants performed in an inner city transplant center. AMR patients were examined for demographic associations and outcomes.

Results: Table 1 examines the demographics of the AMR population.

Table 1 Demographics of study population
	Patients (N)	AA Race (%)	Age (yrs)	Male Gender (%)	SLE (N)	Prior Transplant (%)	HLA Mismatch (N)
AMR	43	95	44.6	72	5	10	4.25
No AMR	675	60	50.3	59	3	13	3.77
p value		p<0.0001	0.006	0.093	0.044	0.682	0.091

Table 2 demonstrates the outcomes of patients with AMR.

Table 2 Outcomes of AMR patients
	Patients (N)	Rejections (N)	Time to Rejection (yrs)	Chronic Rejection (%)	Graft Failure (%)	Death (%)	Follow up (yrs)
AMR	43	2.49	1.25	53	37	19	3.66
No AMR	675	1.25	1.13	19	14	14	3.58
p value		<0.0001	0.654	<0.001	<0.0001	0.427	0.83

All of the patients developing chronic rejection were African Americans (AA).

Conclusions: AMR occurred in a high-risk population of younger AA patients with an association with SLE and lower socioeconomics. What was most worrisome was the 100% of the AMR patients that developed chronic rejection were AA. This indicates AAs especially with lower socioeconomics should be the focus of considerable efforts to insure appropriate resource utilization of a scarce resource.

To cite this abstract in AMA style:

John M, Smith A, Dortonne I, Paramesh A, Killackey M, Lee B, Zhang R, Buell J. Effect of Antibody Mediated Rejection on Long-Term Renal Allograft Function [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/effect-of-antibody-mediated-rejection-on-long-term-renal-allograft-function/. Accessed November 24, 2024.

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