Allograft outcomes of treated children with kidney transplant who developed plasma cell‐rich acute rejection (PCAR): A single center's experience
Introduction PCAR is a rare form of ACR that may compromise renal allografts. This review evaluates the outcomes of a protocol used to treat PCAR (Study group), and compares these outcomes with a matched cohort with ACR (Control group). Methods A retrospective analysis of 138 of pRTRs who underwent...
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| Veröffentlicht in: | Pediatric transplantation 2019-09, Vol.23 (6), p.e13500-n/a |
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| creator | Alhamoud, Issa Huang, Rong Lacelle, Chantale Burguete, Daniel Hendricks, Allen R. Torrealba, Jose R. Seikaly, Mouin G. |
| description | Introduction
PCAR is a rare form of ACR that may compromise renal allografts. This review evaluates the outcomes of a protocol used to treat PCAR (Study group), and compares these outcomes with a matched cohort with ACR (Control group).
Methods
A retrospective analysis of 138 of pRTRs who underwent renal allograft biopsies between January 2008 and November 2016.
Results
Seven biopsies revealed in situ hybridization of EBER‐negative PCAR (5%). Three Study group pRTRs lost their grafts within 3 months after rejection (43%). None of the Control group pRTRs lost their graft during this period. At the time of rejection, eGFR was different between the Control and Study groups (27.0 ± 19.9 mL/min per m2 vs 40.0 ± 10.6 mL/min/1.73 m2, respectively; P |
| doi_str_mv | 10.1111/petr.13500 |
| format | Article |
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PCAR is a rare form of ACR that may compromise renal allografts. This review evaluates the outcomes of a protocol used to treat PCAR (Study group), and compares these outcomes with a matched cohort with ACR (Control group).
Methods
A retrospective analysis of 138 of pRTRs who underwent renal allograft biopsies between January 2008 and November 2016.
Results
Seven biopsies revealed in situ hybridization of EBER‐negative PCAR (5%). Three Study group pRTRs lost their grafts within 3 months after rejection (43%). None of the Control group pRTRs lost their graft during this period. At the time of rejection, eGFR was different between the Control and Study groups (27.0 ± 19.9 mL/min per m2 vs 40.0 ± 10.6 mL/min/1.73 m2, respectively; P < 0.05). Among Study group pRTRs with functioning allografts (n = 4), treatment resulted in an increase in eGFR from nadir levels (27.0 ± 19.9 vs 55.6 ± 18.3 mL/min/1.73 m2, P < 0.05). In the Study group, complications included neutropenia, BK and EBV viremia, and infusion‐related hypotension and hypertension.
Summary
(a) Graft loss in Study group while remaining high (43%) was lower than that reported in the published pediatric literature. (b) Our protocol was associated with improvement in eGFR in all surviving pRTRs within the Study group. (c) No life‐threatening complications or malignancy were reported during the observation period.</description><identifier>ISSN: 1397-3142</identifier><identifier>EISSN: 1399-3046</identifier><identifier>DOI: 10.1111/petr.13500</identifier><identifier>PMID: 31437388</identifier><language>eng</language><publisher>Denmark: Wiley Subscription Services, Inc</publisher><subject>Epidermal growth factor receptors ; Graft rejection ; Kidney transplantation ; Kidney transplants ; Malignancy ; pediatric renal transplant recipients ; plasma cell rich acute rejection</subject><ispartof>Pediatric transplantation, 2019-09, Vol.23 (6), p.e13500-n/a</ispartof><rights>2019 Wiley Periodicals, Inc.</rights><rights>2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3570-31e073026cd7dcc5b8f03ad004dbba14ce9b1fb1f4c326bf32741917951f1c593</citedby><cites>FETCH-LOGICAL-c3570-31e073026cd7dcc5b8f03ad004dbba14ce9b1fb1f4c326bf32741917951f1c593</cites><orcidid>0000-0003-0620-9481</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpetr.13500$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpetr.13500$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31437388$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alhamoud, Issa</creatorcontrib><creatorcontrib>Huang, Rong</creatorcontrib><creatorcontrib>Lacelle, Chantale</creatorcontrib><creatorcontrib>Burguete, Daniel</creatorcontrib><creatorcontrib>Hendricks, Allen R.</creatorcontrib><creatorcontrib>Torrealba, Jose R.</creatorcontrib><creatorcontrib>Seikaly, Mouin G.</creatorcontrib><title>Allograft outcomes of treated children with kidney transplant who developed plasma cell‐rich acute rejection (PCAR): A single center's experience</title><title>Pediatric transplantation</title><addtitle>Pediatr Transplant</addtitle><description>Introduction
PCAR is a rare form of ACR that may compromise renal allografts. This review evaluates the outcomes of a protocol used to treat PCAR (Study group), and compares these outcomes with a matched cohort with ACR (Control group).
Methods
A retrospective analysis of 138 of pRTRs who underwent renal allograft biopsies between January 2008 and November 2016.
Results
Seven biopsies revealed in situ hybridization of EBER‐negative PCAR (5%). Three Study group pRTRs lost their grafts within 3 months after rejection (43%). None of the Control group pRTRs lost their graft during this period. At the time of rejection, eGFR was different between the Control and Study groups (27.0 ± 19.9 mL/min per m2 vs 40.0 ± 10.6 mL/min/1.73 m2, respectively; P < 0.05). Among Study group pRTRs with functioning allografts (n = 4), treatment resulted in an increase in eGFR from nadir levels (27.0 ± 19.9 vs 55.6 ± 18.3 mL/min/1.73 m2, P < 0.05). In the Study group, complications included neutropenia, BK and EBV viremia, and infusion‐related hypotension and hypertension.
Summary
(a) Graft loss in Study group while remaining high (43%) was lower than that reported in the published pediatric literature. (b) Our protocol was associated with improvement in eGFR in all surviving pRTRs within the Study group. (c) No life‐threatening complications or malignancy were reported during the observation period.</description><subject>Epidermal growth factor receptors</subject><subject>Graft rejection</subject><subject>Kidney transplantation</subject><subject>Kidney transplants</subject><subject>Malignancy</subject><subject>pediatric renal transplant recipients</subject><subject>plasma cell rich acute rejection</subject><issn>1397-3142</issn><issn>1399-3046</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kd9qFDEUh4MotlZvfAAJeGErbM2fmcmOd8tSq1CwlHodMsmZbtZMMiYZ173zEQTfsE_SbLd64YUhkMPJx8c5_BB6SckpLefdCDmeUl4T8ggdUt62M06q5vF9LWacVuwAPUtpTQhtqnn1FB2UHhd8Pj9EvxfOhZuo-ozDlHUYIOHQ4xxBZTBYr6wzETze2LzCX63xsC2fyqfRKZ_xZhWwge_gwljo0kuDwhqcu_35K1q9wkpPGXCENehsg8fHl8vF1cl7vMDJ-hsHBfYZ4puE4ccI0YLX8Bw96ZVL8OLhPUJfPpxdLz_OLj6ff1ouLmaa14KUxYAITlijjTBa1928J1wZQirTdYpWGtqO9uVWmrOm6zkTFW2paGvaU123_Agd771jDN8mSFkONu2GVx7ClCTjnBHRtmyHvv4HXYcp-jKdZEyIuohFU6i3e0rHkFKEXo7RDipuJSVyF5XcRSXvoyrwqwfl1A1g_qJ_sikA3QMb62D7H5W8PLu-2kvvAGTcoM8</recordid><startdate>201909</startdate><enddate>201909</enddate><creator>Alhamoud, Issa</creator><creator>Huang, Rong</creator><creator>Lacelle, Chantale</creator><creator>Burguete, Daniel</creator><creator>Hendricks, Allen R.</creator><creator>Torrealba, Jose R.</creator><creator>Seikaly, Mouin G.</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0620-9481</orcidid></search><sort><creationdate>201909</creationdate><title>Allograft outcomes of treated children with kidney transplant who developed plasma cell‐rich acute rejection (PCAR): A single center's experience</title><author>Alhamoud, Issa ; Huang, Rong ; Lacelle, Chantale ; Burguete, Daniel ; Hendricks, Allen R. ; Torrealba, Jose R. ; Seikaly, Mouin G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3570-31e073026cd7dcc5b8f03ad004dbba14ce9b1fb1f4c326bf32741917951f1c593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Epidermal growth factor receptors</topic><topic>Graft rejection</topic><topic>Kidney transplantation</topic><topic>Kidney transplants</topic><topic>Malignancy</topic><topic>pediatric renal transplant recipients</topic><topic>plasma cell rich acute rejection</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Alhamoud, Issa</creatorcontrib><creatorcontrib>Huang, Rong</creatorcontrib><creatorcontrib>Lacelle, Chantale</creatorcontrib><creatorcontrib>Burguete, Daniel</creatorcontrib><creatorcontrib>Hendricks, Allen R.</creatorcontrib><creatorcontrib>Torrealba, Jose R.</creatorcontrib><creatorcontrib>Seikaly, Mouin G.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Alhamoud, Issa</au><au>Huang, Rong</au><au>Lacelle, Chantale</au><au>Burguete, Daniel</au><au>Hendricks, Allen R.</au><au>Torrealba, Jose R.</au><au>Seikaly, Mouin G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Allograft outcomes of treated children with kidney transplant who developed plasma cell‐rich acute rejection (PCAR): A single center's experience</atitle><jtitle>Pediatric transplantation</jtitle><addtitle>Pediatr Transplant</addtitle><date>2019-09</date><risdate>2019</risdate><volume>23</volume><issue>6</issue><spage>e13500</spage><epage>n/a</epage><pages>e13500-n/a</pages><issn>1397-3142</issn><eissn>1399-3046</eissn><abstract>Introduction
PCAR is a rare form of ACR that may compromise renal allografts. This review evaluates the outcomes of a protocol used to treat PCAR (Study group), and compares these outcomes with a matched cohort with ACR (Control group).
Methods
A retrospective analysis of 138 of pRTRs who underwent renal allograft biopsies between January 2008 and November 2016.
Results
Seven biopsies revealed in situ hybridization of EBER‐negative PCAR (5%). Three Study group pRTRs lost their grafts within 3 months after rejection (43%). None of the Control group pRTRs lost their graft during this period. At the time of rejection, eGFR was different between the Control and Study groups (27.0 ± 19.9 mL/min per m2 vs 40.0 ± 10.6 mL/min/1.73 m2, respectively; P < 0.05). Among Study group pRTRs with functioning allografts (n = 4), treatment resulted in an increase in eGFR from nadir levels (27.0 ± 19.9 vs 55.6 ± 18.3 mL/min/1.73 m2, P < 0.05). In the Study group, complications included neutropenia, BK and EBV viremia, and infusion‐related hypotension and hypertension.
Summary
(a) Graft loss in Study group while remaining high (43%) was lower than that reported in the published pediatric literature. (b) Our protocol was associated with improvement in eGFR in all surviving pRTRs within the Study group. (c) No life‐threatening complications or malignancy were reported during the observation period.</abstract><cop>Denmark</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31437388</pmid><doi>10.1111/petr.13500</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-0620-9481</orcidid></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Epidermal growth factor receptors Graft rejection Kidney transplantation Kidney transplants Malignancy pediatric renal transplant recipients plasma cell rich acute rejection |
| title | Allograft outcomes of treated children with kidney transplant who developed plasma cell‐rich acute rejection (PCAR): A single center's experience |
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