Effect of methylprednisolone pulse therapy on chronic active antibody-mediated rejection after kidney transplantation
WEI Jianghao
DOU Gufeng
WANG Zhen
FENG Gang
ZHAO Jie
Abstract：Objective To observe and analyze the effect of methylprednisolone pulse therapy on chronic active anti-body-mediated rejection(caAMR)in kidney transplant recipients.Methods Among the 40 patients diagnosed with caAMR following kidney transplantation,26 patients who did not undergo plasma exchange combined with intravenous im-munoglobulin(IVIG)and rituximab were categorized into two groups:the methylprednisolone therapy group of 12 patients receiving methylprednisolone therapy alone and the non-methylprednisolone therapy group of 14 patients,based on wheth-er they received methylprednisolone pulse therapy or not;the remaining 14 patients who underwent plasma exchange along with IVIG or rituximab were further divided into the methylprednisolone combination therapy group(6 cases)and the other treatment group(8 cases),depending on their receipt of methylprednisolone pulse therapy.All participants in this study(40 cases)were classified into the methylprednisolone therapy group(18 cases)and the control group(22 cases),accord-ing to their administration of methylprednisolone pulse therapy.Kidney allograft function was evaluated by monitoring the changes in creatinine levels and estimated glomerular filtration rate(eGFR)after treatment,with calculations made for both creatinine slope and eGFR slope at six months after treatment.The incidence of infectious complications at six month after treatment was recorded.Follow-up continued until July 31,2023,or until kidney allograft failure occurred,during which the prognosis of renal grafts within each cohort was recorded.Results The median survival time of allograft kidney in the methylprednisolone therapy alone group was significantly longer than that in the non-methylprednisolone therapy group(P<0.05).No significant difference was found in the median survival time of allograft kidney between the methyl-prednisolone combination therapy group and other treatment group(P>0.05).At six months after treatment,the creati-nine slope in the methylprednisolone therapy group was lower than that of the control group,while the eGFR slope was higher in comparison with that of the control group;additionally,the median survival time of allograft kidney was longer than that in the control group(all P<0.05).Conclusions Methylprednisolone pulse therapy in caAMR patients can de-lay the decline of kidney allograft function and prolong the kidney allograft survival,especially for patients with elevated in-dicators of acute kidney injury.
Keywords：chronic active antibody-mediated rejectioncomplications after kidney transplantationmethylprednis-olone pulse therapy
Publication Date：2024-11-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 16-21 )