Recommended Treatment for Antibody-mediated Rejection After Kidney Transplantation : The 2019 Expert Consensus From the Transplantion Society Working Group
Schinstock, Carrie A. (Mayo Clinic William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN)
Mannon, Roslyn B. (Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL)
Budde, K (Charité - Universitätsmedizin Berlin)
Chong, Anita S. (Section of Transplantation, Department of Surgery, The University of Chicago, Chicago, IL)
Haas, Mark (Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA)
Knechtle, Stuart (Duke Transplant Center, Department of Surgery, Duke University School of Medicine, Durham, NC)
Lefaucheur, Carmen (Université de Paris, Department of Transplantation, Saint Louis Hospital, Paris, France)
Montgomery, Robert A. (NYU Langone Transplant Institute)
Nickerson, Peter (Transplant Immunology Laboratory, Shared Health and Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada)
Tullius, Stefan G. (Brigham and Women's Hospital (Boston, Estats Units d'Amèrica))
Ahn, Curie (Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea)
Askar, Medhat (Baylor University Medical Center, Transplant Immunology, Dallas, TX)
Crespo, Marta (Institut Hospital del Mar d'Investigacions Mèdiques)
Chadban, Steven J. (Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, Australia)
Feng, Sandy (Department of Surgery, University of California San Francisco, San Francisco, CA)
Jordan, Stanley C. (Cedars-Sinai Medical Center (West Hollywood, Estats Units d'Amèrica))
Man, Kwan (The University of Hong Kong. Department of Surgery)
Mengel, Michael (University of Alberta. Department of Laboratory Medicine and Pathology)
Morris, Randall E. (Stanford University School of Medicine)
O'Doherty, Inish (Critical Path Institute, Tucson, AZ)
Ozdemir, Binnaz H. (Baskent University (Ankara, Turquia))
Seron, Daniel (Hospital Universitari Vall d'Hebron)
Tambur, Anat R. (Northwestern University (Chicago, Estats Units d'Amèrica). Comprehensive Transplant Center)
Tanabe, Kazunari (Tokyo Women's Medical University. Department of Urology)
Taupin, Jean-Luc (Université Paris Diderot)
O'Connell, Philip J. (University of Sydney)
Universitat Autònoma de Barcelona

Fecha:	2020
Resumen:	With the development of modern solid-phase assays to detect anti-HLA antibodies and a more precise histological classification, the diagnosis of antibody-mediated rejection (AMR) has become more common and is a major cause of kidney graft loss. Currently, there are no approved therapies and treatment guidelines are based on low-level evidence. The number of prospective randomized trials for the treatment of AMR is small, and the lack of an accepted common standard for care has been an impediment to the development of new therapies. To help alleviate this, The Transplantation Society convened a meeting of international experts to develop a consensus as to what is appropriate treatment for active and chronic active AMR. The aim was to reach a consensus for standard of care treatment against which new therapies could be evaluated. At the meeting, the underlying biology of AMR, the criteria for diagnosis, the clinical phenotypes, and outcomes were discussed. The evidence for different treatments was reviewed, and a consensus for what is acceptable standard of care for the treatment of active and chronic active AMR was presented. While it was agreed that the aims of treatment are to preserve renal function, reduce histological injury, and reduce the titer of donor-specific antibody, there was no conclusive evidence to support any specific therapy. As a result, the treatment recommendations are largely based on expert opinion. It is acknowledged that properly conducted and powered clinical trials of biologically plausible agents are urgently needed to improve patient outcomes.
Ayudas:	Instituto de Salud Carlos III RD16-0009-0030 Instituto de Salud Carlos III PI18-01704 Instituto de Salud Carlos III PI18-01382
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Coefficient of variation ; Concentration dose ratio ; Protocol biopsies ; Renal transplantation ; Tacrolimus ; Time in therapeutic range
Publicado en:	Transplantation, Vol. 104 (april 2020) , p. 911-922, ISSN 1534-6080

DOI: 10.1097/TP.0000000000003095
PMID: 31895348

12 p, 537.1 KB

El registro aparece en las colecciones:
Artículos > Artículos de investigación
Artículos > Artículos publicados