Predicting Factors for Long-Term Results of OKT3 Therapy in Steroid-Resistant Acute Rejection Following Cadaveric Renal Transplantation

Rostaing, Lionel; Chabannier, Marie-Hélène; Modesto, Anne; Rouzaud, Anne; Cisterne, Jean‐Marc; Tkaczuk, Jean; Durand, Dominique

doi:10.1016/s0041-1345(98)00195-x

Cited by 6 publications

(6 citation statements)

References 7 publications

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“…Of the 26 studies that reported on the association between acute rejec- tion and graft survival, five were conducted prospectively (17,20,28,35,36). The definitions for acute rejection were based on clinical and pathologic rejections alone (nϭ8) (15-17, 20, 23, 26, 30, 37) or on the presence of changes in serum creatinine (nϭ10) (14,18,19,22,24,28,32,35,36,38). Two studies defined acute rejection as confirmed or suspected in patients who received antirejection treatment (nϭ2) (8,29), and no definition was listed in the remaining six studies (10 -13, 25, 34).…”

Section: Rejectionmentioning

confidence: 99%

“…The risk of graft loss associated with multiple acute rejection episodes has been reported to be as much as two times that was observed with one acute rejection episode (34). The effect of severity of acute rejection episodes on the risk of graft loss was investigated in patients with steroid resistant acute rejections compared with those who were not steroid resistant (28) and in patients with acute rejection who were classified according to their Banff grade (24). Although the findings suggested that severe acute rejection (steroid resistant or Banff grade II and III) was associated with increased risk of graft failure, this was based on limited number of patients.…”

Section: Rejectionmentioning

confidence: 99%

“…Ten studies (8,13,23,24,26,27,31,33,34,37) assessed the association between graft function and graft survival (Fig. 3).…”

Section: Graft Functionmentioning

confidence: 99%

“…3). Graft function was measured by creatinine clearance (31,37), serum creatinine (8,23,24,26,33,34), chronic decline in the inverse of serum creatinine (13), and glomerular filtration rate (27). Overall, all studies with the exception of one (24), were consistent in showing deteriorating graft function being associated with significant increase in the risk of graft failure; however, the reported magnitude of the associated risk varied considerably, ranging from risk ratio of 1.0 (23) (serum creatinine at 1 year) to 9.7 (26) (serum creatinine Ͼ400 mol/ L).…”

Section: Graft Functionmentioning

confidence: 99%

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Acute Rejection and Chronic Nephropathy: A Systematic Review of the Literature

Levy²,

Briggs³

et al. 2009

Transplantation

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Section: Rejectionmentioning

confidence: 99%

Section: Rejectionmentioning

confidence: 99%

“…Ten studies (8,13,23,24,26,27,31,33,34,37) assessed the association between graft function and graft survival (Fig. 3).…”

Section: Graft Functionmentioning

confidence: 99%

Section: Graft Functionmentioning

confidence: 99%

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Acute Rejection and Chronic Nephropathy: A Systematic Review of the Literature

Levy²,

Briggs³

et al. 2009

Transplantation

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“…In spite of varying conclusions from different studies regarding the effect of CS avoidance on recurrent hepatitis C, a meta-analysis of the available randomized trials indicates that the relative risk of HCV recurrence reached statistical significance ( p = 0.03) for a better outcome with CS avoidance [112]. In addition, there is general agreement about including treated episodes of acute cellular rejection and pulse therapy with CS, as well as longer duration/higher cumulative exposure to CS, among the factors which highly influence the negative impact of liver transplantation in HCV + patients [113-115]. These data suggest that the benefit of CS avoidance may be real, even if small.…”

Section: Introductionmentioning

confidence: 99%

Hepatitis C virus infection in the immunocompromised host: a complex scenario with variable clinical impact

et al. 2012

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The relationship between Hepatitis C Virus (HCV) infection and immunosuppression is complex and multifaceted. Although HCV-related hepatocytolysis is classically interpreted as secondary to the attack by cytotoxic T lymphocytes against infected cells, the liver disease is usually exacerbated and more rapidly evolutive in immunosuppressed patients. This generally occurs during the immunosuppression state, and not at the reconstitution of the host response after immunosuppressive therapy discontinuation. The field of immunosuppression and HCV infection is complicated both by the different outcome observed in different situations and/or by contrasting data obtained in the same conditions, with several still unanswered questions, such as the opportunity to modify treatment schedules in the setting of post-transplant follow-up. The complexity of this field is further complicated by the intrinsic tendency of HCV infection in itself to lead to disorders of the immune system. This review will briefly outline the current knowledge about the pathogenesis of both hepatic and extrahepatic HCV-related disorders and the principal available data concerning HCV infection in a condition of impairment of the immune system. Attention will be especially focused on some conditions - liver or kidney transplantation, the use of biologic drugs and cancer chemotherapy - for which more abundant and interesting data exist.

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Clinical and Molecular Profiling to Develop a Potential Prediction Model for the Response to Alemtuzumab Therapy for Acute Kidney Transplant Rejection

Hullegie-Peelen

Zwan

Groningen

et al. 2022

Clin Pharma and Therapeutics

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Alemtuzumab, a monoclonal antibody that depletes CD52‐bearing immune cells, is an effective drug for the treatment of severe or glucocorticoid‐resistant acute kidney transplant rejection (AR). Patient‐specific predictions on treatment response are, however, urgently needed, given the severe side effects of alemtuzumab. This study developed a multidimensional prediction model with the aim of generating clinically useful prognostic scores for the response to alemtuzumab. Clinical and histological characteristics were collected retrospectively from patients who were treated with alemtuzumab for AR. In addition, targeted gene expression profiling of AR biopsy tissues was performed. Least absolute shrinkage and selection operator (LASSO) logistic regression modeling was used to construct the ALEMtuzumab for Acute Rejection (ALEMAR) prognostic score. Response to alemtuzumab was defined as patient and allograft survival and at least once an estimated glomerular filtration rate (eGFR) > 30 mL/min/1.73 m2 during the first 6 months after treatment. One hundred fifteen patients were included, of which 84 (73%) had a response to alemtuzumab. The ALEMAR‐score accurately predicted the chance of response. Gene expression analysis identified 13 differentially expressed genes between responders and nonresponders. The combination of the ALEMAR‐score and selected genes resulted in improved predictions of treatment response. The present preliminary prediction model is potentially helpful for the development of stratified alemtuzumab treatment for acute kidney transplant rejection but requires validation.

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Predicting Factors for Long-Term Results of OKT3 Therapy in Steroid-Resistant Acute Rejection Following Cadaveric Renal Transplantation

Cited by 6 publications

References 7 publications

Acute Rejection and Chronic Nephropathy: A Systematic Review of the Literature

Acute Rejection and Chronic Nephropathy: A Systematic Review of the Literature

Hepatitis C virus infection in the immunocompromised host: a complex scenario with variable clinical impact

Clinical and Molecular Profiling to Develop a Potential Prediction Model for the Response to Alemtuzumab Therapy for Acute Kidney Transplant Rejection

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