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Published on: May 7, 2019
Study of acute antibody-mediated rejection in renal allograft biopsies
K V Kanodia1, A V Vanikar, H L Trivedi
1Department of Pathology, Laboratory Medicine, Transfusion Services, and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney diseases and Research Centre, Ahmedabad, India. ikdrcad1@sancharnet.in
Introduction:
Acute B-cell-mediated rejection (AMR) was ill-defined until the 6(th) Banff meeting establishing the criteria. We performed a retrospective analysis of renal allograft biopsies to evaluate immune injury with reference to the Ahmedabad Tolerance Induction Protocols (ATIP).
Methods:
We evaluated renal allograft biopsies belonging to 3 groups: group A patients (n = 120) underwent a modified ATIP with addition of mesenchymal stem cells, anti-B-cell antibodies, and higher target-specific irradiation; group B patients (n = 351) belong to the old ATIP; and group C (n = 142) were controls who opted out of ATIP. The majority were biopsied 2 or 3 times. Biopsies were subdivided:
Results:
At
Conclusion:
The modified ATIP has reduced immunosuppressive drug dose requirements and lessened ATIR; however, AMR, although significantly less than controls, needs to be addressed.
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