Prognosis of chronic active antibody-mediated rejection in kidney transplantation

VernacularTitle:慢性活动性抗体介导的排斥反应的远期预后及影响因素分析
Author: Xue LI ¹ ; Dongrui CHENG ; Jiqiu WEN ; Kenan XIE ; Xuefeng NI ; Jinsong CHEN
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1. 南京大学医学院附属金陵医院（东部战区总医院）　国家肾脏疾病临床医学研究中心　210016
From: Chinese Journal of Organ Transplantation 2020;41(3):157-162
CountryChina
Language:Chinese
Abstract: Objective:To explore the long-term prognosis of chronic active antibody-mediated rejection(cABMR)and independent risk factors for prognosis.Methods:A single-center retrospective cohort with biopsy-proven cABMR was examined. Renal biopsies were scored according to the criteria of Banff 2017. The primary outcome was death-censored graft failure defined as resuming dialysis or estimated glomerular filtration rate(eGFR)decreased to <15 ml·(min·1.73m 2) -1. The prognostic significance of clinical and histopathologic parameters were determined by a Cox proportional hazard model. Results:Clinical data from 149 cases were available for analysis with a median follow-up of 28(15~51)months. In a multivariable model, ci + ct score(HR 3.0; 95 % CI 1.9~4.7), cg score(HR 1.9; 95 %CI 1.1~3.1), eGFR(HR 2.0; 95 % CI 1.3~3.2)and proteinuria(HR 2.0; 95 %CI 1.3~3.2)were independent predictors of primary outcome.Conclusions:eGFR, proteinuria, Banff ci + ct and Banff cg are independent risk factors for the prognosis of cABMR.