Date: Tuesday, May 2, 2017
Session Name: Poster Session D: Kidney: Acute Cellular Rejection
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Endarteritis post renal transplantation is regarded as T-cell mediated acute rejection by Banff classification. Recently, results from DNA microarrays suggested that endovasculitis did not represent T-cell mediated acute rejection exactly and its effect on allograft outcomes was unclear.
Totally 217 cases of biopsy-proved acute cellular rejection were documented in our renal transplantation system from Sep. 2001 to Dec. 2014. There was only 1 case lost- to-follow. After 24 cases excluded because of tubulointerstitial rejection, 192 cases were included with 95 Class IA, 16 Class IB, 79 Class IIA, and 2 Class IIB. According to the presence of endarteritis and CD20+B cell infiltration, all 192 cases were divided into CD20-endarteritis-group (n=33), CD20+ endarteritis-group (n=78),CD20-endarteritis+ group (n=46), and CD20+endarteritis+group (n=35). Baseline information, serum creatine and GFR before and after treatment, steroid resistance, reversal rate, graft loss and survival were analyzed.
There was no significant difference between groups in baseline information. Average time to rejection was separately 182 days, 374 days, 493 days and 729 days. The percentage of steroid and antibodies combination treatment was separately 42.8%, 63.0%, 54.5% and 35.9% (p=0.022). Graft loss was separately 8.6% (3/35), 23.9% (11/46), 42.4% (14/33) and 23.1% (18/78) (p=0.013). Endarteritis + group showed earlier rejection (291 days vs. 659 days) but higher reversal rate (77.5% (86/111) vs. 90.1% (73/81), p=0.022). GFR in endarteritis- group was significantly higher before and at rejection but signigicantly lower 3-60 months after biopsy. Endarteritis + group had a much lower graft loss rate (17.3% (14/81) vs. 28.8% (32/111), p=0.064). Although general survivals were similar, survival rate after rejection in endarteritis + group was higher. The best survival was observed in CD20+ endarteritis + group.
Acute cellular rejection with endarteritis showed better outcomes after treatment. Endarteritis with CD20+B cell infiltration implies lower graft loss and better graft survival.
CITATION INFORMATION: Wang R, Jiang Y, Wu J, Peng W, Huang H, Chen J. The Effect of Histological Isolated Endarteritis and Solid Endoarteritis Combined with CD20 Positive B Cell Infiltration Appeared in Acute Cellular Rejection on Kidney Allograft Survival. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Wang R, Jiang Y, Wu J, Peng W, Huang H, Chen J. The Effect of Histological Isolated Endarteritis and Solid Endoarteritis Combined with CD20 Positive B Cell Infiltration Appeared in Acute Cellular Rejection on Kidney Allograft Survival. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/the-effect-of-histological-isolated-endarteritis-and-solid-endoarteritis-combined-with-cd20-positive-b-cell-infiltration-appeared-in-acute-cellular-rejection-on-kidney-allograft-survival/. Accessed July 22, 2019.
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