Mid-Term Outcomes after Treatment for Antibody-Mediated Rejection by De Novo Donor-Specific HLA Antibody in Renal Transplant Recipients: Does Early Treatment Lead to Better Outcomes?
1Nagoya Daini Red Cross Hospital, Nagoya, Japan, 2Nephrology, Nagoya Daini Red Cross Hospital, Nagoya, Japan
Meeting: 2020 American Transplant Congress
Abstract number: B-066
Keywords: Graft survival, HLA antibodies, Kidney transplantation, Rejection
Session Information
Session Name: Poster Session B: Kidney Chronic Antibody Mediated Rejection
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: De novo donor-specific HLA antibody (DSA) and antibody-mediated rejection (ABMR) are strongly associated with late allograft loss in renal transplant recipients. However, the impact of therapeutic intervention with the current treatment options for ABMR remains unclear. This study aimed to elucidate the efficacy of treatment for ABMR.
*Methods: Sixty-seven patients who had de novo DSA underwent diagnostic biopsy for ABMR, and these patients were classified into three groups: ABMR-free group (N=40), clinical ABMR group (N=15), and subclinical ABMR group (N=12). The ABMR-positive groups were treated mainly with double filtration plasmapheresis followed by rituximab and steroid pulse. The patient characteristics and graft outcomes were compared between the groups.
*Results: The clinical and subclinical ABMR groups were younger and had a higher number and MFI of de novo DSA than the ABMR-free group. The graft survival in the clinical ABMR group was significantly lower than that in the ABMR-free group, but the subclinical ABMR group had surprisingly good graft survival comparable to the ABMR-free group (43.3% vs 100% vs 94.2% 5 years after diagnostic biopsy in the clinical ABMR, subclinical ABMR, and ABMR-free groups, respectively, P<0.001).
*Conclusions: Our findings indicated that early therapeutic intervention for patients with de novo DSA may improve graft survival.
To cite this abstract in AMA style:
Okada M, Tomosugi T, Hiramitsu T, Narumi S, Watarai Y, Kanda A, Futamura K, Goto N, Takeda A. Mid-Term Outcomes after Treatment for Antibody-Mediated Rejection by De Novo Donor-Specific HLA Antibody in Renal Transplant Recipients: Does Early Treatment Lead to Better Outcomes? [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/mid-term-outcomes-after-treatment-for-antibody-mediated-rejection-by-de-novo-donor-specific-hla-antibody-in-renal-transplant-recipients-does-early-treatment-lead-to-better-outcomes/. Accessed May 16, 2025.« Back to 2020 American Transplant Congress