2026-04-17T15:52:15Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/68832025-10-24T10:37:01Zcom_2072_378070com_2072_378040col_2072_378092

Change in Estimated GFR and Risk of Allograft Failure in Patients Diagnosed With Late Active Antibody-mediated Rejection Following Kidney Transplantation Irish, William Nickerson, Peter Astor, Brad C. Chong, Edward Wiebe, Chris Moreso Mateos, Francesc Serón Micas, Daniel Institut Català de la Salut [Irish W] Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, NC. [Nickerson P, Wiebe C] Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada. [Astor BC] Department of Medicine, University of Wisconsin, Madison, WI. Department of Population Health Sciences, University of Wisconsin, Madison, WI. [Chong E] Vitaeris, Inc., Vancouver, BC, Canada. [Moreso F, Seron D] Vall d’Hebron Hospital Universitari, Barcelona, Spain Vall d'Hebron Barcelona Hospital Campus Ronyons - Trasplantació - Complicacions Rebuig (Biologia) ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Transplantation::Organ Transplantation::Surgical Procedures, Operative::Kidney Transplantation Other subheadings::Other subheadings::Other subheadings::/adverse effects PHENOMENA AND PROCESSES::Immune System Phenomena::Transplantation Immunology::Host vs Graft Reaction::Graft Rejection TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::trasplante::trasplante de órganos::intervenciones quirúrgicas::trasplante de riñón Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos FENÓMENOS Y PROCESOS::fenómenos del sistema inmunitario::inmunología del trasplante::reacción huésped contra injerto::rechazo del injerto Malaltia renal en fase terminal; Trasplantament de ronyó Enfermedad renal en etapa terminal; Transplante de riñón End-stage renal disease; Kidney Transplant Background. There are challenges in designing adequate, well-controlled studies of patients with active antibody-mediated rejection (AMR) after kidney transplantation (KTx). Methods. We assessed the functional relationship between change in estimated glomerular filtration rate (eGFR) following the diagnosis of AMR and the risk of subsequent death-censored graft failure using the joint modeling framework. We included recipients of solitary KTx between 1995 and 2013 at 4 transplant centers diagnosed with biopsy-proven active AMR at least 1 year post-KTx, who had a minimum of 3-year follow-up. Results. A total of 91 patients across participating centers were included in the analysis. Of the 91 patients, n = 54 patients (59%) met the death-censored graft failure endpoint and n = 62 patients (68%) met the all-cause graft failure composite endpoint. Kaplan-Meier death-censored graft survival rates at 12, 36, and 60 months postdiagnosis of AMR pooled across centers were 88.9%, 58.9%, and 36.4%, respectively. Spaghetti plots indicated a linear trend in the change in eGFR, especially in the first 12 months postdiagnosis of active AMR. A significant change in eGFR was observed within the first 12 months postdiagnosis of active AMR, getting worse by a factor of −0.757 mL/min/1.73 m2 per month during the 12-month analysis period (a delta of −9.084 mL/min/1.73 m2 at 1 y). Notably, an extrapolated 30% improvement in the slope of eGFR in the first 12 months was associated with a 10% improvement in death-censored graft failure at 5 years. Conclusions. If prospectively validated, this study may inform the design of pivotal clinical trials for therapies for late AMR. 2022-01-24T14:26:46Z 2022-01-24T14:26:46Z 2020 2021-03 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Irish W, Nickerson P, Astor BC, Chong E, Wiebe C, Moreso F, et al. Change in Estimated GFR and Risk of Allograft Failure in Patients Diagnosed With Late Active Antibody-mediated Rejection Following Kidney Transplantation. Transplantation. 2021 Mar;105(3):648–59. 0041-1337 https://hdl.handle.net/11351/6883 10.1097/TP.0000000000003274 33617203 000639592700035 http://hdl.handle.net/11351/6883 eng Transplantation;105(3) https://doi.org/doi: 10.1097/TP.0000000000003274 Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess application/pdf Wolters Kluwer Health Scientia