دورية أكاديمية
Infectious complications and graft outcome following treatment of acute antibody-mediated rejection after kidney transplantation: A nationwide cohort study
| العنوان: | Infectious complications and graft outcome following treatment of acute antibody-mediated rejection after kidney transplantation: A nationwide cohort study |
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| المؤلفون: | Perrottet, Nancy, Fernández-Ruiz, Mario, Binet, Isabelle, Dickenmann, Michael, Dahdal, Suzan, Hadaya, Karine, Müller, Thomas, Schaub, Stefan, Koller, Michael, Rotman, Samuel, Moll, Solange, Hopfer, Helmut, Venetz, Jean-Pierre, Aubert, Vincent, Bühler, Léo, Steiger, Jurg, Manuel, Oriol, Pascual, Manuel, Golshayan, Déla, and the Swiss Transplant Cohort Study (STCS) |
| المصدر: | http://lobid.org/resources/990155701200206441Test#!, 16(4):e0250829. |
| سنة النشر: | 2021 |
| المجموعة: | Publisso (ZB MED-Publikationsportal Lebenswissenschaften) |
| مصطلحات موضوعية: | Transplant rejection, Medical risk factors, Bacterial diseases, Intravenous injections, Antibody therapy, Opportunistic infections, Antiviral therapy, Renal transplantation |
| الوصف: | Acute antibody-mediated rejection (AMR) remains a challenge after kidney transplantation (KT). As there is no clear-cut treatment recommendation, accurate information on current therapeutic strategies in real-life practice is needed. KT recipients from the multicenter Swiss Transplant Cohort Study treated for acute AMR during the first post-transplant year were included retrospectively. We aimed at describing the anti-rejection protocols used routinely, as well as patient and graft outcomes, with focus on infectious complications. Overall, 65/1669 (3.9%) KT recipients were treated for 75 episodes of acute AMR. In addition to corticosteroid boluses, most common therapies included plasmapheresis (56.0%), intravenous immunoglobulins (IVIg) (38.7%), rituximab (25.3%), and antithymocyte globulin (22.7%). At least one infectious complication occurred within 6 months from AMR treatment in 63.6% of patients. Plasmapheresis increased the risk of overall (hazard ratio [HR]: 2.89; P-value = 0.002) and opportunistic infection (HR: 5.32; P-value = 0.033). IVIg exerted a protective effect for bacterial infection (HR: 0.29; P-value = 0.053). The recovery of renal function was complete at 3 months after AMR treatment in 67% of episodes. One-year death-censored graft survival was 90.9%. Four patients (6.2%) died during the first year (two due to severe infection). In this nationwide cohort we found significant heterogeneity in therapeutic approaches for acute AMR. Infectious complications were common, particularly among KT recipients receiving plasmapheresis. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | https://repository.publisso.de/resource/frl:6452962Test; https://doi.org/10.1371/journal.pone.0250829Test; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087104Test/; https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0250829#sec015Test |
| DOI: | 10.1371/journal.pone.0250829 |
| DOI: | 10.1371/journal.pone.0250829#sec015 |
| الإتاحة: | https://doi.org/10.1371/journal.pone.0250829Test https://repository.publisso.de/resource/frl:6452962Test https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087104Test/ https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0250829#sec015Test |
| حقوق: | CC BY 4.0 |
| رقم الانضمام: | edsbas.6EAD5F3F |
| قاعدة البيانات: | BASE |
| DOI: | 10.1371/journal.pone.0250829 |
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