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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Antibody-mediated rejection (ABMR) remains the leading cause of kidney allograft failure and return to the transplant waiting list. Currently, there is no widely accepted standardized therapeutic regimen for its management. Most available evidence focuses on early or active forms of ABMR, whereas data on late or chronic-active rejection are considerably more limited. In particular, there is a lack of information regarding therapeutic options, the evolution of chronic lesions, and graft outcomes in this context, underscoring the need for studies specifically addressing this population.
The aim of this study was to evaluate kidney allograft survival in patients with chronic-active ABMR (CA-ABMR) treated with first-line anti-rejection therapy and to compare their outcomes with those of patients with active ABMR (A-ABMR). As a secondary objective, we assessed the progression of chronic injury in both groups.
We conducted a single-center comparative cohort study at a tertiary care center in Mexico City between 2011 and 2023, integrating clinical data and renal histopathologic findings from patients diagnosed with ABMR. All patients received first-line anti-rejection therapy, consisting of corticosteroids, plasmapheresis, intravenous immunoglobulin (IVIG), and/or corticosteroids plus rituximab. A follow-up biopsy was performed 3 to 8 months after treatment. The progression of transplant glomerulopathy and graft survival were compared between CA-ABMR and A-ABMR groups.
Among 451 biopsies from 198 patients with ABMR, 38 were classified as CA-ABMR at initial diagnosis. The median time from transplantation to diagnosis was longer in the CA-ABMR group (127 months, IQR 58–167) compared with the A-ABMR group (66 months, IQR 13–86). Graft survival from the time of ABMR diagnosis did not differ significantly between groups (5-year survival: 78% in A-ABMR vs. 69.8% in CA-ABMR, p = 0.283). The presence of transplant glomerulopathy >cg1b at diagnosis was not associated with an increased risk of graft loss (HR 0.99, 95% CI 0.3–2.9) (Figure 1).
During follow-up, transplant glomerulopathy developed within the first year in 10.6% of patients with A-ABMR despite first-line treatment, whereas 83.8% of patients with CA-ABMR showed no further progression of chronic glomerulopathy (Δcg > 1) after therapy.
First-line anti-rejection therapy in patients with chronic-active ABMR was associated with allograft survival comparable to that of patients without chronic lesions, supporting its use in this subgroup. A substantial proportion of patients with active lesions progressed to chronic injury within the first year, raising the question of whether treatment should continue to be limited to those without established chronic changes.
