Antibody-mediated rejection implies a poor prognosis in kidney transplantation: Results from a single center

2018 ◽  
Vol 32 (10) ◽  
pp. e13392 ◽  
Author(s):  
Gaetano Ciancio ◽  
Jeffrey J. Gaynor ◽  
Giselle Guerra ◽  
Junichiro Sageshima ◽  
David Roth ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Poor Prognosis ◽  
Single Center ◽  
Antibody Mediated Rejection

Treatment of Antibody-Mediated Rejection After Kidney Transplantation - 10 Years’ Experience With Apheresis at a Single Center

2016 ◽  
Vol 20 (3) ◽  
pp. 240-245 ◽  
Author(s):  
Jakob Gubensek ◽  
Jadranka Buturovic-Ponikvar ◽  
Aljosa Kandus ◽  
Miha Arnol ◽  
Jelka Lindic ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Single Center ◽  
Antibody Mediated Rejection

Results after combined heart and kidney transplantation – a single center experience

2008 ◽  
Vol 56 (S 1) ◽  
Author(s):  
Y Li ◽  
M Strüber ◽  
B Gohrbandt ◽  
S Fischer ◽  
AL Meyer ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Single Center ◽  
Single Center Experience

Acute Rejection Following Kidney Transplantation: State-of-the-Art and Future Perspectives

2020 ◽  
Vol 26 (28) ◽  
pp. 3468-3496
Author(s):  
Emilio Rodrigo ◽  
Marcio F. Chedid ◽  
David San Segundo ◽  
Juan C.R. San Millán ◽  
Marcos López-Hoyos
Keyword(s):  
Kidney Transplantation ◽  
Acute Rejection ◽  
Rescue Therapy ◽  
Standard Of Care ◽  
Rejection Rate ◽  
New Drugs ◽  
High Dose ◽  
Current Standard ◽  
Antibody Mediated Rejection ◽  
Cellular Rejection

: Although acute renal graft rejection rate has declined in the last years, and because an adequate therapy can improve graft outcome, its therapy remains as one of the most significant challenges for pharmacists and physicians taking care of transplant patients. Due to the lack of evidence highlighted by the available metaanalyses, we performed a narrative review focused on the basic mechanisms and current and future therapies of acute rejection in kidney transplantation. : According to Kidney Disease/Improving Global Outcomes (KDIGO) guidelines, both clinical and subclinical acute rejection episodes should be treated. Usually, high dose steroids and basal immunosuppression optimization are the first line of therapy in treating acute cellular rejection. Rabbit antithymocytic polyclonal globulins are used as rescue therapy for recurrent or steroid-resistant cellular rejection episodes. Current standard-of-care (SOC) therapy for acute antibody-mediated rejection (AbMR) is the combination of plasma exchange with intravenous immunoglobulin (IVIG). Since a significant rate of AbMR does not respond to SOC, different studies have analyzed the role of new drugs such as Rituximab, Bortezomib, Eculizumab and C1 inhibitors. Lack of randomized controlled trials and heterogenicity among performed studies limit obtaining definite conclusions. Data about new direct and indirect B cell and plasma cell depleting agents, proximal and terminal complement blockers, IL-6/IL-6R pathway inhibitors and antibody removal agents, among other promising drugs, are reviewed.

Kidney Transplantation over the Age of 65: A Single-Center Experience

2011 ◽  
Vol 77 (9) ◽  
pp. 1269-1271
Author(s):  
Naing Htike ◽  
Charles Shieh ◽  
Keith Superdock ◽  
James Lim ◽  
Francisco Badosa
Keyword(s):  
Kidney Transplantation ◽  
Single Center ◽  
Single Center Experience

scholarly journals B-cell activating factor BAFF as a novel alert marker for the immunological risk stratification after kidney transplantation

2021 ◽  
Author(s):  
Antonia Margarete Schuster ◽  
N. Miesgang ◽  
L. Steines ◽  
C. Bach ◽  
B. Banas ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
B Cell ◽  
Graft Function ◽  
Risk Profile ◽  
Kidney Transplant Recipients ◽  
Post Transplantation ◽  
Antibody Mediated Rejection ◽  
B Cell Activating Factor ◽  
Medium Risk ◽  
Patients At Risk

AbstractThe B cell activating factor BAFF has gained importance in the context of kidney transplantation due to its role in B cell survival. Studies have shown that BAFF correlates with an increased incidence of antibody-mediated rejection and the development of donor-specific antibodies. In this study, we analyzed a defined cohort of kidney transplant recipients who were treated with standardized immunosuppressive regimens according to their immunological risk profile. The aim was to add BAFF as an awareness marker in the course after transplantation to consider patient’s individual immunological risk profile. Included patients were transplanted between 2016 and 2018. Baseline data, graft function, the occurrence of rejection episodes, signs of microvascular infiltration, and DSA kinetics were recorded over 3 years. BAFF levels were determined 14 d, 3 and 12 months post transplantation. Although no difference in graft function could be observed, medium-risk patients showed a clear dynamic in their BAFF levels with low levels shortly after transplantation and an increase in values of 123% over the course of 1 year. Patients with high BAFF values were more susceptible to rejection, especially antibody-mediated rejection and displayed intensified microvascular inflammation; the combination of high BAFF + DSA puts patients at risk. The changing BAFF kinetics of the medium risk group as well as the increased occurrence of rejections at high BAFF values enables BAFF to be seen as an awareness factor. To compensate the changing immunological risk, a switch from a weaker induction therapy to an intensified maintenance therapy is required.

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