Chronic Active Antibody-Mediated Rejection and Kidney Allograft Survival: A 14-Year Single-Center Retrospective Analysis
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Abstract
Background: Chronic active antibody-mediated rejection (ABMR) is a significant cause of graft loss in kidney transplants. The current treatment strategies have not been very effective. The present study examined kidney allograft survival after diagnosis and treatment of chronic active ABMR and explored factors associated with allograft survival.
Methods: 144 kidney transplants were identified from 2007 to 2021. Thirty patients had ABMR, and 15 cases in 12 patients were classified as having chronic active ABMR according to the 2017 Banff classification.
Results: The average time from transplantation to the diagnosis of chronic active ABMR was six years. The median graft survival after the diagnosis was 2.6 years. Fifty-eight percent of the patients lost their grafts. The average serum creatinine and urine protein/creatinine ratio at the time of diagnosis of chronic active ABMR were 2.6 mg/dL and 1.5 g/g, respectively. Higher serum creatinine was the only factor significantly associated with graft failure. The association between heavier proteinuria and graft loss was also noted, but the difference did not reach statistical significance.
Conclusion: Chronic active ABMR was associated with poor graft survival. Decreased allograft function at diagnosis was significantly associated with graft failure.
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