Journal article
Antibody-mediated rejection in pediatric kidney transplant recipients: A report from the Pediatric Nephrology Research Consortium
Pediatric transplantation, Vol.28(3), e14734
05/2024
DOI: 10.1111/petr.14734
PMCID: PMC11013566
PMID: 38602171
Abstract
Antibody-mediated rejection (AMR) is a major cause of kidney allograft loss. There is a paucity of large-scale pediatric-specific data regarding AMR treatment outcomes.
Data were obtained from 14 centers within the Pediatric Nephrology Research Consortium. Kidney transplant recipients aged 1-18 years at transplant with biopsy-proven AMR between 2009 and 2019 and at least 12 months of follow-up were included. The primary outcome was graft failure or an eGFR <20 mL/min/1.73 m
at 12 months following AMR treatment. AMR treatment choice, histopathology, and DSA class were also examined.
We reviewed 123 AMR episodes. Median age at diagnosis was 15 years at a median 22 months post-transplant. The primary outcome developed in 27.6%. eGFR <30 m/min/1.73 m
at AMR diagnosis was associated with a 5.6-fold higher risk of reaching the composite outcome. There were no significant differences in outcome by treatment modality. Histopathology scores and DSA class at time of AMR diagnosis were not significantly associated with the primary outcome.
In this large cohort of pediatric kidney transplant recipients with AMR, nearly one-third of patients experienced graft failure or significant graft dysfunction within 12 months of diagnosis. Poor graft function at time of diagnosis was associated with higher odds of graft failure.
Details
- Title: Subtitle
- Antibody-mediated rejection in pediatric kidney transplant recipients: A report from the Pediatric Nephrology Research Consortium
- Creators
- Isa F Ashoor - Boston Children's HospitalRachel M Engen - University of Wisconsin–MadisonDechu Puliyanda - Cedars-Sinai Medical CenterNicole Hayde - Children's Hospital at MontefioreCaitlin G Peterson - University of UtahRima S Zahr - University of Tennessee Health Science CenterSonia Solomon - Maria Fareri Children's HospitalMahmoud Kallash - Nationwide Children's HospitalRouba Garro - Children's Healthcare of AtlantaAmrish Jain - Children's Hospital of MichiganLyndsay A Harshman - University of IowaScott T McEwen - University of Minnesota Children's HospitalAsifhusen Mansuri - Augusta UniversityMathew J Gregoski - Medical University of South CarolinaKatherine E Twombley - Medical University of South Carolina
- Resource Type
- Journal article
- Publication Details
- Pediatric transplantation, Vol.28(3), e14734
- DOI
- 10.1111/petr.14734
- PMID
- 38602171
- PMCID
- PMC11013566
- NLM abbreviation
- Pediatr Transplant
- eISSN
- 1399-3046
- Grant note
- NCATS NIH HHS
- Language
- English
- Date published
- 05/2024
- Academic Unit
- Nephrology, Dialysis and Transplantation; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Radiation Oncology
- Record Identifier
- 9984584906102771
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