2018
DOI: 10.1111/petr.13334
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Acute cellular rejection treatment outcomes stratified by Banff grade in pediatric kidney transplant

Abstract: Introduction There are limited data to guide optimal treatment strategies for acute cellular rejection (ACR) based on Banff grade for pediatric kidney transplant recipients. This report reviews a large pediatric transplant center's experience with ACR. Materials and Methods A retrospective analysis of pediatric kidney transplant recipients at our center from 2007 to 2014 was performed. Primary outcomes were incidence of graft failure and graft function one year following ACR based on Banff grade and treatment … Show more

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Cited by 5 publications
(9 citation statements)
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“…Despite that it is generally accepted that inadequately treated rejection is adversely associated with allograft function and patient survival, 1,5,37–40 there is limited evidence on the optimal treatment for TCMR in children 10,28 . Our study demonstrates that the standard treatment for rejection is ineffective.…”
Section: Discussionmentioning
confidence: 62%
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“…Despite that it is generally accepted that inadequately treated rejection is adversely associated with allograft function and patient survival, 1,5,37–40 there is limited evidence on the optimal treatment for TCMR in children 10,28 . Our study demonstrates that the standard treatment for rejection is ineffective.…”
Section: Discussionmentioning
confidence: 62%
“…Good evidence is particularly lacking in borderline TCMR, resulting in inconsistencies of treatment approaches among and within centers, which range from no treatment to increasing maintenance immunosuppression alone to high-dose IV steroids. 1,2,9,10,41 In this study, 85% of borderline TCMR cases were treated, which may reflect a bias toward treatment in the two participating centers with an expressed commitment to FUB. In addition, the standard practice at each center was to persistently treat refractory rejection until it was completely resolved on subsequent FUB, which may explain the lack of difference in long-term graft outcome in those who were initially refractory to treatment on the first FUB.…”
Section: Discussionmentioning
confidence: 81%
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“…Antithymocyte globulin antibody therapies, including eATG and rATG, demonstrated improved reversal of ACR compared with steroids for treatment of first rejection episode, but considerations need to be made regarding the negative sequelae of eATG or rATG administration. A recent single center analysis also reinforced the efficacy of rATG at improving renal function during ACR episodes in the pediatric KTR population 149 …”
Section: Acute Rejection Treatment In Pediatric Kidney Transplantationmentioning
confidence: 86%