{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T19:46:54Z","timestamp":1767901614943,"version":"3.49.0"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,9,23]],"date-time":"2018-09-23T00:00:00Z","timestamp":1537660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Two major barriers to achieving long\u2010term graft survival include patient nonadherence in taking the prescribed immunosuppression and antibody\u2010mediated rejection(<jats:styled-content style=\"fixed-case\">AMR<\/jats:styled-content>). We were therefore interested in determining the prognostic impact of developing an <jats:styled-content style=\"fixed-case\">AMR<\/jats:styled-content> component to rejection in a prospective randomized trial of 200 kidney transplant recipients who received dual induction therapy (<jats:styled-content style=\"fixed-case\">rATG<\/jats:styled-content> combined with either daclizumab or alemtuzumab) and planned early corticosteroid withdrawal. With a median follow\u2010up of 96\u00a0months post\u2010transplant, 40\/200 developed a first <jats:styled-content style=\"fixed-case\">BPAR<\/jats:styled-content>; 9\/200 developed a second <jats:styled-content style=\"fixed-case\">BPAR<\/jats:styled-content>. An <jats:styled-content style=\"fixed-case\">AMR<\/jats:styled-content> component to rejection was observed in 70% (28\/40) of cases. Percentages having C4d deposition, histopathologic evidence of acute <jats:styled-content style=\"fixed-case\">AMR<\/jats:styled-content>, and presence of <jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content>s\/non\u2010<jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content>s at the time of first developing the <jats:styled-content style=\"fixed-case\">AMR<\/jats:styled-content> component were 64.3% (18\/28), 60.7% (17\/28), and 53.6% (15\/28), respectively. Development of an <jats:styled-content style=\"fixed-case\">AMR<\/jats:styled-content> component was associated with a significantly higher death\u2010censored graft failure rate following rejection in comparison with the patient state of experiencing <jats:styled-content style=\"fixed-case\">BPAR<\/jats:styled-content> but without developing an <jats:styled-content style=\"fixed-case\">AMR<\/jats:styled-content> component (estimated hazard ratio: 4.52, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01). The observed percentage developing graft failure following development of an <jats:styled-content style=\"fixed-case\">AMR<\/jats:styled-content> component was 53.6% (15\/28) vs only 20.0%(3\/15) if it was not observed. Actuarial death\u2010censored graft survival at 60\u00a0months following development of an <jats:styled-content style=\"fixed-case\">AMR<\/jats:styled-content> component was 28.3 \u00b1 11.9%. In summary, it appears that more effective <jats:styled-content style=\"fixed-case\">AMR<\/jats:styled-content> prevention\/treatment strategies are warranted.<\/jats:p>","DOI":"10.1111\/ctr.13392","type":"journal-article","created":{"date-parts":[[2018,8,29]],"date-time":"2018-08-29T17:33:06Z","timestamp":1535563986000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Antibody\u2010mediated rejection implies a poor prognosis in kidney transplantation: Results from a single center"],"prefix":"10.1111","volume":"32","author":[{"given":"Gaetano","family":"Ciancio","sequence":"first","affiliation":[{"name":"The Lillian Jean Kaplan Renal Transplant Center Miami Transplant Institute  Miami Florida"},{"name":"Department of Surgery University of Miami Miller School of Medicine Jackson Memorial Hospital  Miami 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Center Miami Transplant Institute  Miami Florida"},{"name":"Department of Surgery University of Miami Miller School of Medicine Jackson Memorial Hospital  Miami Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Roth","sequence":"additional","affiliation":[{"name":"The Lillian Jean Kaplan Renal Transplant Center Miami Transplant Institute  Miami Florida"},{"name":"Division of Nephrology Department of Medicine University of Miami Miller School of Medicine Jackson Memorial Hospital  Miami Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Chen","sequence":"additional","affiliation":[{"name":"The Lillian Jean Kaplan Renal Transplant Center Miami Transplant Institute  Miami Florida"},{"name":"Department of Surgery University of Miami Miller School of Medicine Jackson Memorial Hospital  Miami Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Warren","family":"Kupin","sequence":"additional","affiliation":[{"name":"The Lillian Jean Kaplan Renal Transplant Center Miami Transplant Institute  Miami Florida"},{"name":"Division of Nephrology Department of Medicine University of Miami Miller School of Medicine Jackson Memorial Hospital  Miami Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adela","family":"Mattiazzi","sequence":"additional","affiliation":[{"name":"The Lillian Jean Kaplan Renal Transplant Center Miami Transplant Institute  Miami Florida"},{"name":"Division of Nephrology Department of Medicine University of Miami Miller School of Medicine Jackson Memorial Hospital  Miami Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lissett","family":"Tueros","sequence":"additional","affiliation":[{"name":"The Lillian Jean Kaplan Renal Transplant Center Miami Transplant Institute  Miami 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