{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T22:26:13Z","timestamp":1787610373215,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T00:00:00Z","timestamp":1712793600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Antibody\u2010mediated rejection (AMR) is a major cause of kidney allograft loss. There is a paucity of large\u2010scale pediatric\u2010specific data regarding AMR treatment outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were obtained from 14 centers within the Pediatric Nephrology Research Consortium. Kidney transplant recipients aged 1\u201318\u2009years at transplant with biopsy\u2010proven AMR between 2009 and 2019 and at least 12\u2009months of follow\u2010up were included. The primary outcome was graft failure or an eGFR &lt;20\u2009mL\/min\/1.73 m<jats:sup>2<\/jats:sup> at 12\u2009months following AMR treatment. AMR treatment choice, histopathology, and DSA class were also examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We reviewed 123 AMR episodes. Median age at diagnosis was 15\u2009years at a median 22\u2009months post\u2010transplant. The primary outcome developed in 27.6%. eGFR &lt;30\u2009m\/min\/1.73 m<jats:sup>2<\/jats:sup> at AMR diagnosis was associated with a 5.6\u2010fold higher risk of reaching the composite outcome. There were no significant differences in outcome by treatment modality. Histopathology scores and DSA class at time of AMR diagnosis were not significantly associated with the primary outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this large cohort of pediatric kidney transplant recipients with AMR, nearly one\u2010third of patients experienced graft failure or significant graft dysfunction within 12\u2009months of diagnosis. Poor graft function at time of diagnosis was associated with higher odds of graft failure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14734","type":"journal-article","created":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T09:45:51Z","timestamp":1712828751000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Antibody\u2010mediated rejection in pediatric kidney transplant recipients: A report from the Pediatric Nephrology Research Consortium"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0539-4021","authenticated-orcid":false,"given":"Isa F.","family":"Ashoor","sequence":"first","affiliation":[{"name":"Department of Pediatrics Harvard Medical School and Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0584-7951","authenticated-orcid":false,"given":"Rachel 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Nephrology and Hypertension University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rima S.","family":"Zahr","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Nephrology and Hypertension University of Tennessee Health Sciences Center  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2636-6647","authenticated-orcid":false,"given":"Sonia","family":"Solomon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Maria Fareri Children's Hospital, New York Medical College, Boston Children's Health Physicians  Valhalla New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Kallash","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Nationwide Children's Hospital  Columbus Ohio 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