EFFECT OF DIFFERENT TREATMENT REGIMENS ON KIDNEY GRAFT FUNCTION AND MORTALITY IN PATIENTS WITH A DIAGNOSIS OF ANTIBODY MEDIATED REJECTION

E-Poster

https://storage.unitedwebnetwork.com/files/1099/2adc226143b0bb6fad87c3f22dc62455.pdf

Abstract Title

First Name *

Hugo Leonardo

Last Name *

Reynoso de la Torre

Co-author 1

Jorge Andrade Sierra jorg_andrade@hotmail.com Instituto Mexicano del Seguro Social Department of Nephrology and Organ Transplant Unit, Specialties Hospital, National Western Medical Center Guadalajara, Jalisco

Co-author 2

Ana Cristina Hernández Pugh cristy.hdz.pugh@gmail.com Instituto Mexicano del Seguro Social Department of Nephrology and Organ Transplant Unit, Specialties Hospital, National Western Medical Center Guadalajara, Jalisco

Co-author 3

José Ignacio Cerrillos Gutierrez gugo_leonardo@hotmail.com Instituto Mexicano del Seguro Social Department of Nephrology and Organ Transplant Unit, Specialties Hospital, National Western Medical Center Guadalajara, Jalisco

Co-author 4

Enrique Rojas Campos erojascampos@yahoo.com.mx Instituto Mexicano del Seguro Social Medical Research Unit in Kidney Diseases, Specialties Hospital, National Western Medical Center Guadalajara, Jalisco

Co-author 5

Co-author 6

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

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Co-author 15

Introduction

The optimal treatment for Antibody mediated rejection (AMR) remains uncertain, and its presence causes up to 60% of kidney grafts loss.

Methods

A retrospective cohort from May-2016 to June 2022, that included 176 patients ≥18 years old, hospitalized with graft dysfunction and histopathological diagnosis of AMR to receive treatment, were categorized into 3 groups; 1. Plasmapheresis (PF) + Intravenous immunoglobulin (IVIG), 2. IVIG + Rituximab (RTX) 3. Steroids and immunosuppression treatment optimization.

Results

On average, 63% of patients were men, and a majority were transplanted with a living donor kidney (89%), showing a median of age 32 ± 9; baseline serum creatinine (CrS) was 1.15 and during the rejection, 2.75 mg/dL; timing of biopsy 6 ± 5 years; C4d positive (68%) comparing groups of treatments there were no significant difference by CrS at the end of the follow up, episodes of infections was 27%, 20% and 10% (P=0.61), mortality was 6.8%, 2.5% and 5.8% each group (P=0.47).

Conclusions

There is no significant difference in graft function and mortality between treatment groups but in a logistic regression analysis predictive variable of poor graft prognosis were; CrS greater than 2.5 mg/dl at the beginning of treatment, using steroids and immunosuppression optimization treatment, greater chronicity and being younger at the time of diagnosis.

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