{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T10:44:27Z","timestamp":1788345867990,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T00:00:00Z","timestamp":1670371200000},"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":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Chronic active antibody\u2010mediated rejection (CAAMR) constitutes a dominant form of late allograft failure. Several treatment strategies directed at CAAMR have been attempted but proven ineffective at delaying kidney function decline or reducing donor\u2010specific antibodies (DSA). We describe our single\u2010center experience using tocilizumab in patients with CAAMR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective analysis using electronic medical records. 38 kidney transplant recipients at Columbia University Irving Medical Center who had been prescribed tocilizumab and followed for at least 3 months between August 2013 through December 2019 were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Tocilizumab use was associated with a decrease in the rate of estimated glomerular filtration rate (eGFR) decline in the 6 months following treatment initiation as compared to the 3 months before tocilizumab was initiated (difference between slopes before and after initiation of treatment = 2.6 mL\/min\/1.73 m<jats:sup>2<\/jats:sup> (SE\u00a0=\u00a0.8, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.002) per month for up to 6 months following Tocilizumab initiation). Allograft biopsies showed significant improvement in interstitial inflammation scores (score 1(0,1) to 0 (0,1), <jats:italic>p<\/jats:italic> = .03) while other histologic scores remained stable. There was no significant change in proteinuria or DSA titers post\u2010treatment with tocilizumab.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Treatment of CAAMR with tocilizumab was associated with a decrease in the rate of eGFR decline and a reduction in interstitial inflammation scores in patients with CAAMR.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.14853","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T13:19:30Z","timestamp":1668777570000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Tocilizumab for the treatment of chronic antibody mediated rejection in kidney transplant recipients"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2105-0130","authenticated-orcid":false,"given":"Pascale","family":"Khairallah","sequence":"first","affiliation":[{"name":"Section of Nephrology Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelief","family":"Robbins\u2010Juarez","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Duke University Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shefali","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Nephrology Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaqar","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Medicine SUNY University at Buffalo  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Toma","sequence":"additional","affiliation":[{"name":"Jersey Coast Nephrology and Hypertension Associates  Brick New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3740-1062","authenticated-orcid":false,"given":"Hilda","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Division of Nephrology Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey K.","family":"Dube","sequence":"additional","affiliation":[{"name":"Division of Nephrology Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"King","sequence":"additional","affiliation":[{"name":"Division of Nephrology Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5305-9685","authenticated-orcid":false,"given":"Sumit","family":"Mohan","sequence":"additional","affiliation":[{"name":"Division of Nephrology Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1823-0117","authenticated-orcid":false,"given":"Syed Ali","family":"Husain","sequence":"additional","affiliation":[{"name":"Division of Nephrology Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Morris","sequence":"additional","affiliation":[{"name":"Division of Nephrology Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell John","family":"Crew","sequence":"additional","affiliation":[{"name":"Division of Nephrology Columbia University Irving Medical Center  New York New York 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