{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T10:35:56Z","timestamp":1762252556739,"version":"3.41.2"},"reference-count":41,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,7,13]],"date-time":"2017-07-13T00:00:00Z","timestamp":1499904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"The National Health and Medical Research Council of Australia"},{"name":"Roche Australia and Monash Postgraduate Scholarships SRC and LA"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Chronic antibody\u2010mediated rejection (<jats:styled-content style=\"fixed-case\">cAMR<\/jats:styled-content>) is the major cause of premature renal allograft loss and is resistant to therapy with 12\u2010month graft failure of up to 50% reported. We examined the duration of graft survival and associates of graft failure in patients with donor\u2010specific antibody\u2010positive <jats:styled-content style=\"fixed-case\">cAMR<\/jats:styled-content> and treatment\u2010resistant peritubular capillaritis between June 2007 and October 2010. Those with advanced interstitial fibrosis (n=5) were excluded. Included patients (n=24) received treatment with high\u2010dose intravenous immunoglobulin and fixed\u2010dose rituximab (500\u00a0mg). Compared with previous reports, the study group experienced prolonged graft survival (median 82.1\u00a0months). Graft loss was predicted by <jats:styled-content style=\"fixed-case\">eGFR<\/jats:styled-content> and degree of proteinuria at diagnosis but not by donor\u2010specific HLA antibody class or intensity, nor individual or summed Banff scores. Allograft biopsies were further examined for infiltrating leukocyte subtypes and location with high numbers of glomerular leukocytes, particularly macrophages, independently associated with an increased risk of graft failure. This study suggests that patients with <jats:styled-content style=\"fixed-case\">cAMR<\/jats:styled-content> and persistent microcirculatory inflammation, excluding those with advanced histological damage, can expect prolonged graft survival when treated with <jats:styled-content style=\"fixed-case\">IVI<\/jats:styled-content>g and rituximab. Trial level evidence is required to validate this observation. Further examination of the role of macrophages in <jats:styled-content style=\"fixed-case\">cAMR<\/jats:styled-content> is warranted.<\/jats:p>","DOI":"10.1111\/ctr.13037","type":"journal-article","created":{"date-parts":[[2017,6,22]],"date-time":"2017-06-22T15:48:44Z","timestamp":1498146524000},"source":"Crossref","is-referenced-by-count":12,"title":["Long\u2010term graft survival in patients with chronic antibody\u2010mediated rejection with persistent peritubular capillaritis treated with intravenous immunoglobulin and rituximab"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5109-165X","authenticated-orcid":false,"given":"William R.","family":"Mulley","sequence":"first","affiliation":[{"name":"Department of Nephrology Monash Medical Centre  Clayton Vic. Australia"},{"name":"Department of Medicine Centre for Inflammatory Diseases Monash University  Clayton Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis L.","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Nephrology Monash Medical Centre  Clayton Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharmila","family":"Ramessur Chandran","sequence":"additional","affiliation":[{"name":"Department of Nephrology Monash Medical Centre  Clayton Vic. Australia"},{"name":"Department of Medicine Centre for Inflammatory Diseases Monash University  Clayton Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Longano","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology Monash Medical Centre  Clayton Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liv A. R.","family":"Amos","sequence":"additional","affiliation":[{"name":"Department of Nephrology Monash Medical Centre  Clayton Vic. Australia"},{"name":"Department of Medicine Centre for Inflammatory Diseases Monash University  Clayton Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevan R.","family":"Polkinghorne","sequence":"additional","affiliation":[{"name":"Department of Nephrology Monash Medical Centre  Clayton Vic. Australia"},{"name":"Department of Medicine Centre for Inflammatory Diseases Monash University  Clayton Vic. Australia"},{"name":"Department of Epidemiology and Preventive Medicine Monash University  Prahran Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Nikolic\u2010Paterson","sequence":"additional","affiliation":[{"name":"Department of Nephrology Monash Medical Centre  Clayton Vic. Australia"},{"name":"Department of Medicine Centre for Inflammatory Diseases Monash University  Clayton Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Kanellis","sequence":"additional","affiliation":[{"name":"Department of Nephrology Monash Medical Centre  Clayton Vic. Australia"},{"name":"Department of Medicine Centre for Inflammatory Diseases Monash University  Clayton Vic. 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