Treatment of Antibody-Mediated Renal Allograft Rejection: Improving Step by Step
Table 1
Patient characteristics.
Group RLP ()
Group BLP ()
Group BHP ()
First/repeat transplantation
8/4
7/4
11/0
n.s.
Donor age
52.4 ± 13.8
42.3 ± 14.9
52.1 ± 15.2
n.s.
Living/deceased donor
5/7
5/6
7/4
n.s.
Interval between transplantation and diagnosis (months)
34.6 ± 56.9
58.1 ± 51.4
46.1 ± 44.7
n.s.
Early/late antibody-mediated rejection
6/6
2/9
2/9
n.s.
Pathology scoring
Glomerulitis (g)
0.8 ± 1.1
0.9 ± 1.0
1.6 ± 1.2
n.s.
Peritubular capillaritis (ptc)
1.1 ± 1.1
0.8 ± 1.1
1.5 ± 1.0
n.s.
Intimal arteritis (v)
0.7 ± 0.9
0.3 ± 0.6
0.5 ± 0.7
n.s.
Transplant glomerulopathy (cg)
1.1 ± 1.2
2.2 ± 1.3
0.8 ± 1.3
0.049 (BLP versus BHP)
C4d (immunohistochemistry)
1.4 ± 1.3
2.0 ± 1.1
1.3 ± 1.3
n.s.
IVIG dose (g)
30
30
120 (80–150)
<0.001 (BHP versus RLP and BHP versus BLP)
Maintenance immunosuppression after diagnosis
Steroids
12
11
11
n.s.
Cyclosporine A
0
3
1
n.s.
Tacrolimus
12
6
10
0.01 (RLP versus BLP)
Everolimus
0
2
0
n.s.
Mycophenolic acid
12
11
11
n.s.
Median observation time after treatment (months)
101 (39–137)
88 (73–90)
64 (55–71)
<0.001 (BHP versus RLP); 0.015 (BHP versus BLP)
Group RLP, rituximab + low-dose IVIG + plasmapheresis; group BLP, bortezomib + low-dose IVIG + plasmapheresis; group BHP, bortezomib + high-dose IVIG + plasmapheresis. IVIG, intravenous immunoglobulin. Comparison between groups was carried out using Fisher’s exact test for categorical variables and Kruskal-Wallis test with Dunn-Bonferroni post hoc test for continuous variables.
