{"id":9355,"date":"2024-11-15T04:09:25","date_gmt":"2024-11-15T04:09:25","guid":{"rendered":"https:\/\/www.kauveryhospital.com\/ima-journal\/?p=9355"},"modified":"2025-04-09T10:21:03","modified_gmt":"2025-04-09T10:21:03","slug":"comparative-analysis-of-clinical-profile-and-outcomes-of-antibody-mediated-rejection-alone-and-combined-antibody-and-t-cell-mediated-rejection-single-centre-study","status":"publish","type":"post","link":"https:\/\/www.kauveryhospital.com\/ima-journal\/ima-journal-november-2024\/comparative-analysis-of-clinical-profile-and-outcomes-of-antibody-mediated-rejection-alone-and-combined-antibody-and-t-cell-mediated-rejection-single-centre-study\/","title":{"rendered":"COMPARATIVE ANALYSIS OF CLINICAL PROFILE AND OUTCOMES OF ANTIBODY MEDIATED REJECTION ALONE AND COMBINED ANTIBODY AND T CELL MEDIATED REJECTION – SINGLE CENTRE STUDY"},"content":{"rendered":"

[vc_row][vc_column][vc_column_text]<\/p>\n

INTRODUCTION<\/b><\/strong><\/h2>\n

Antibody mediated rejection (ABMR) is recognised as one of the biggest challenges in renal transplant.(1) It is\u00a0one of the major determinants of graft survival.(2)ABMR is distinct from T cell mediated rejection (TCMR) but\u00a0shares\u00a0inflammation elements with\u00a0TCMR.<\/p>\n

AIM<\/b><\/strong>\u00a0<\/b><\/strong>OF STUDY<\/b><\/strong>\u00a0<\/strong><\/h2>\n
    \n
  1. To study the clinical profile of renal transplant recipients with antibody mediated rejection ABMR alone and combined ABMR and TCMR.<\/li>\n<\/ol>\n
      \n
    1. Toassess and compare the outcomes in these patients.<\/li>\n<\/ol>\n

      METHODOLOGY<\/b><\/strong><\/h2>\n

      This is a retrospective observational study. The data of a total of 18 renal transplant recipients who had biopsy\u00a0proven ABMR(either alone or with combined TCMR) were included in this study. They were divided into 2\u00a0groups. Group 1 – recipients with ABMR alone and Group 2 – recipients with combined ABMR and TCMR.\u00a0They were studied for their clinical profile. Their outcomes were assessed in terms of\u00a0doubling of serum\u00a0creatinine,\u00a0graft\u00a0loss, all infections,\u00a0death from\u00a0all causes\u00a0and these\u00a0were compared\u00a0between the\u00a0two group<\/p>\n

      RESULTS<\/b><\/strong><\/h2>\n

      Group 1 had a total of 6 recipients and group 2 had 11 recipients. Baseline characteristics and outcomes were comparable between the two groups. There was no significant difference between both the groups in terms of age, gender, donor type. Anti thymocyte globulin(ATG) was given as an induction agent for 2 patients in group 1 and 6 patients in group 2. In both the groups, the time of ABMR was mostly more than 6 months post transplant. The mean creatinine at the time of rejection was 2.14+\/-0.34 mg\/dl in group 1 and 3.34+\/-1.45 mg\/dl in group2. Infections such as bacterial and Cytomegalovirus, were seen more in group 2. Doubling of serum creatinine was seen in 2 patients (33.3%) in group 1 and 5 patients (45.4%) in group 2. 1 patient (16.6%) in group1 and 3 patients (27.2%) in group 2 had graft loss. Death (all cause) was seen in 2 patients(18.1%) in group 2 and none in group 1.<\/p>\n

      \"\"<\/b><\/strong><\/h2>\n

      CONCLUSION<\/b><\/strong><\/h2>\n

      The group with combined antibody and cell mediated rejection had a increased risk of doubling of serum\u00a0creatinine and graft loss. Infectious complications were more in group 2. ABMR is an important barrier in terms\u00a0of\u00a0graft survival.(3) The evidence for\u00a0efficacy of treatment for ABMR\u00a0is\u00a0unsatisfactory.<\/p>\n

      REFERENCES<\/b><\/strong>\u00a0<\/strong><\/h2>\n
        \n
      1. Sellar\u00e9s J, de Freitas DG, Mengel M, et al.. Understanding the causes of kidney transplant failure: the dominantrole of antibody -mediated rejection and nonadherence. Am J Transplant 2012; 12:388\u2013399.<\/li>\n
      2. Balasubramanian Karthikeyan, Raj K. Sharma,Sonia Mehrotra, Amit Gupta, Anupama Kaul,Dharmendra S.Bhaudauria, andNarayan Prasad – Comparative Analysis of Determinants and Outcome of Early and Late\u00a0Acute\u00a0Antibody Mediated Rejection (ABMR)Indian\u00a0J Nephrol. 2023 Jan-Feb;\u00a033: 22\u201327<\/li>\n
      3. Vural Taner Yilmaza, Ozgur Dandinb, Abdullah Kisaoglub, Ali Avanazb, Davut Kamacic, Havva SerapTorud, Ismail Demiryilmazb, Sadi Koksoye, Bulent Aydinlib, and Huseyin Kocaka – Prognosis andTreatment for Active and Chronic Antibody-Mediated Rejection in Renal Transplant Recipients; Single\u00a0Center\u00a0Experience- Transplantation Proceedings, 54, 1809\u22121815\u00a0(2022)<\/li>\n<\/ol>\n

        Authors<\/strong><\/h2>\n

        \"\"Dr Yashilha D
        \n<\/b><\/strong>Nephrology PG Resident<\/em>
        \nKauvery Hospital, Chennai<\/p>\n

         <\/p>\n

         <\/p>\n

         <\/p>\n

        \"Dr.Dr R Balasubramaniyam<\/b><\/strong>
        \nChief Nephrologist<\/em>
        \nKauvery Hospital, Chennai<\/p>\n

         <\/p>\n

         <\/p>\n

        \"\"Dr B Balaji Kirushnan<\/strong>
        \nNephrologist<\/em>
        \nKauvery Hospital, Chennai[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"

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