17 November 2020: Original Paper
Treatment of Antibody-Mediated Rejection After Kidney Transplantation: Immunological Effects, Clinical Response, and Histological Findings
Marcos Vinicius de Sousa 1ABCDEF* , Ana Claudia Gonçalez 2CD , Ricardo de Lima Zollner 3DE , Marilda Mazzali 1ADEDOI: 10.12659/AOT.925488
Ann Transplant 2020; 25:e925488
Table 3 Histopathological findings at diagnosis of antibody-mediated rejection (AMR) and after treatment.
| General | AMR ≤24 months post-Tx | AMR >24 months post-Tx | |||||||
|---|---|---|---|---|---|---|---|---|---|
| At AMR | After treatment | p | At AMR | After treatment | p | At AMR | After treatment | p | |
| Number of graft biopsies, n (%) | 42 (100.0) | 30 (71.4) | 19 (100.0) | 10 (52.6) | 23 (100.0) | 20 (66.7) | |||
| Time (months) | 39.6±43.8* | 2.4±3.0** | 6.7±7.2 | 2.9±3.4 | 66.9±42.7 | 2.2±2.9 | |||
| Glomerular sclerosis (%) | 11.0±20.7 | 16.4±21.9 | 0.29# | 2.8±4.8 | 1.8±5.5 | 0.60# | 17.8±26.0 | 23.8±23.5 | 0.44# |
| Banff score | |||||||||
| i (0 to 3) | 1.0±0.8 | 0.5±0.6 | # | 0.8±0.7 | 0.7±0.7 | 0.22# | 1.3±0.9 | 0.6±0.6 | # |
| t (0 to 3) | 1.0±0.9 | 0,7±0.9 | 0.15# | 0.7±0.9 | 1.0±1.3 | 0.45# | 1.3±0.9 | 0.5±0.6 | # |
| v (0 to 3) | 0.1±0.4 | 0.0±0.0 | 0.16# | 0.2±0.6 | 0.0±0.0 | 0.36# | 0.1±0.3 | 0.0±0.0 | 0.32# |
| g (0 to 3) | 1.1±0.8 | 0.8±1.0 | 0.25# | 0.8±0.8 | 0.4±0.5 | 0.16# | 1.3±0.8 | 1.0±1.2 | 0.38# |
| ptc (0 to 3) | 1.6±1.0 | 1.3±0.9 | 0.15# | 1.2±1.2 | 1.1±1.1 | 0.81# | 1.9±0.7 | 1.3±0.9 | 0.02# |
| MVI g + ptc (0 to 6) | 2.6±1.7 | 2.0±1.8 | 0.18# | 1.9±1.8 | 1.4±1.2 | 0.39# | 3.2±1.4 | 2.4±1.9 | 0.13# |
| C4d (0 to 3) | 2.2±1.0 | 1.4±1.2 | # | 1.8±1.2 | 1.0±1.0 | 0.12# | 2.5±0.8 | 1.5±1.3 | # |
| ci (0 to 3) | 1.0±0.9 | 1.4±1.0 | 0.17# | 0.6±0.7 | 1.2±0.9 | 0.07# | 1.4±0.8 | 1.4±1.0 | 0.94# |
| ct (0 to 3) | 1.2±0.9 | 1.5±0.9 | 0.10# | 0.8±0.8 | 1.5±0.7 | 0.03# | 1.5±0.8 | 1.5±0.9 | 0.93# |
| Electron microscopy, n (%) | |||||||||
| IC deposits | 7 (16.7) | 2 (6.2) | 0.76## | 3 (15.8) | 1 (10.0) | 0.99## | 4 (17.4) | 2 (10.0) | 0.97## |
| Podocyte effacement | 10 (23.8) | 3 (9.4) | 0.62## | 4 (21.0) | 2 (20.0) | >0.99## | 6 (26.1) | 3 (15.0) | 0.93## |
| GBM duplication | 7 (16.7) | 3 (9.4) | 0.93## | 2 (10.5) | 1 (10.0) | >0.99## | 5 (21.7) | 5 (25.0) | 0.99## |
| AMR – antibody-mediated rejection; i – inflammation; t – tubulitis; v – intimal arteritis; g – glomerulitis; ptc – peritubular capillaritis; MVI – microvascular inflammation; ci – interstitial fibrosis; ct – tubular atrophy; IC – immune complex; GBM – glomerular basement membrane. * Time post-transplant; ** time post-AMR treatment; # unpaired t-test; ## Chi-square test. | |||||||||