Introduction and Objective:Plasma cell rich rejection (PCR) has historically been associated with poor outcomes, but there has been minimal data published to date on pediatric kidney transplant patients with plasma cell rich rejection. Define the incidence and clinical outcomes of pediatric patients with PCR.

Methods: We performed a retrospective chart review of pediatric kidney transplant patients that had kidney biopsies from 1/1/2011-1/1/2016 performed as standard of care . Inclusion criteria included any pediatric kidney transplant patient age <18yrs at the time of biopsy.

Results: 6 patients had PCR during this time. Average GFR at diagnosis was 37.23 ml/min/1.73m2. All 6 patients had some form of ACR. All 6 patients had DSA either to Class II only (33%) or to Class I and II (67%). Sixty-severn percent (4/6) of patients had ESRD 12 months post PCR treatment. Four patients were female and 4 admitted to being non-compliance with their baseline immunosuppression, and the other two were suspicious for non-adherence.

Conclusion: In our group, PCR was associated with the presence of DSA and a low GFR. The majority of children with PCR lost their graft within one year of treatment which suggests a very poor prognosis. More research needs to be done to look at why some children with PCR respond to treatment and some do not.

CITATION INFORMATION: Moussa O, Self S, Twombley K. Outcomes for Plasma Cell Rich Rejection in Pediatric Kidney Transplant Patients. Am J Transplant. 2017;17 (suppl 3).

« Back to 2017 American Transplant Congress