Evidence map›Paper›PMID 35657013›Full record

ArticleClinical transplantation2022

Long term tolerability and clinical outcomes associated with tocilizumab in the treatment of refractory antibody mediated rejection (AMR) in pediatric renal transplant recipients.

Meghan Pearl, Patricia L Weng, Lucia Chen, Aditi Dokras, Helen Pizzo, Jonathan Garrison, Carrie Butler, Jennifer Zhang, Elaine F Reed, Irene K Kim and 8 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical transplantation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
4.8field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 27 citations in OpenAlex.

  1. The role of early immunotherapy in rasmussen's encephalitis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Article
  2. Article
  3. Review
  4. Article
  5. Article
  6. Tocilizumab-Based Treatment of Microvascular Inflammation in Kidney Transplant Recipients: A Retrospective Study.Transplant international : official journal of the European Society for Organ Transplantation · 2025
    Article
  7. Article
  8. Article
  9. Review
  10. Review
  11. Targeting inerleukin-6 for renoprotection.Frontiers in immunology · 2024
    Review
  12. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 3 institutions in 1 country.

Meghan PearlDepartment of Pediatrics, University of California Los Angeles, Los Angeles, California, USA.ORCID 0000-0002-6070-4793
Patricia L WengDepartment of Pediatrics, University of California Los Angeles, Los Angeles, California, USA.ORCID 0000-0003-2020-2729
Lucia ChenDepartment of Pediatrics, University of California Los Angeles, Los Angeles, California, USA.ORCID 0000-0001-5971-4209
Aditi DokrasDepartment of Pediatrics, University of California Los Angeles, Los Angeles, California, USA.
Helen PizzoComprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID 0000-0003-2997-7483
Jonathan GarrisonComprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID 0000-0002-9066-4497
Carrie ButlerDepartment of Pathology, University of California Los Angeles, Los Angeles, California, USA.ORCID 0000-0001-7783-7819
Jennifer ZhangDepartment of Pathology, University of California Los Angeles, Los Angeles, California, USA.
Elaine F ReedDepartment of Pathology, University of California Los Angeles, Los Angeles, California, USA.
Irene K KimComprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID 0000-0002-6605-8104
Jua ChoiComprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID 0000-0003-3744-111X
Mark HaasComprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Xiaohai ZhangComprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID 0000-0002-7188-7855
Ashley VoComprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Eileen Tsai ChambersDepartment of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA.
Robert EttengerDepartment of Pediatrics, University of California Los Angeles, Los Angeles, California, USA.
Stanley JordanComprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Dechu PuliyandaComprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Cedars-Sinai Medical Center · USUniversity of California, Los Angeles · USDuke University · US

Funding

Understanding the Interface of Allo and Auto-Immunity: The Impact of Angiotensin II Type 1 Receptor Antibodies in Pediatric Kidney Transplant RecipientsK23AI139335 · NIAID · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI PEARL, MEGHAN HALEY · 2019 to 2023
$1.0M
NIAID NIH HHS K23 AI139335
6 · The paper itself

Abstract

backgroundTreatment options for antibody-mediated rejection (AMR) are limited. Recent studies have shown that inhibition of interleukin-6 (IL-6)/interleukin-6 receptor (IL-6R) signaling can reduce inflammation and slow AMR progression.

methodsWe report our experience using monthly tocilizumab (anti-IL6R) in 25 pediatric renal transplant recipients with AMR, refractory to IVIg/Rituximab. From January 2013 to June 2019, a median (IQR) of 12 (6.019.0) doses of tocilizumab were given per patient. Serial assessments of renal function, biopsy findings, and HLA DSA (by immunodominant HLA DSA [iDSA] and relative intensity score [RIS]) were performed.

resultsMedian (IQR) time from transplant to AMR was 41.4 (24.367.7) months, and time from AMR to first tocilizumab was 10.6 (8.317.6) months. At median (IQR) follow up of 15.8 (8.435.7) months post-tocilizumab initiation, renal function was stable except for 1 allograft loss. There was no significant decrease in iDSA or RIS. Follow up biopsies showed reduction in peritubular capillaritis (p = .015) and C4d scoring (p = .009). The most frequent adverse events were cytopenias.

conclusionsTocilizumab in pediatric patients with refractory AMR was well tolerated and appeared to stabilize renal function. The utility of tocilizumab in the treatment of AMR in this population should be further explored.

Indexed as

IsoantibodiesKidney TransplantationAntibodies, Monoclonal, HumanizedBiopsyChildGraft RejectionGraft SurvivalHLA AntigensHumansKidneyAntibodies, Monoclonal, HumanizedHLA AntigensIsoantibodiestocilizumabantibody-mediated rejectionIL-6kidneymonoclonal antibody therapypediatrictocilizumabtransplant

Identifiers

PMID35657013
PMCPMC9378624
OpenAlexW4281740253

What OpenQuestion holds

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LicenceTDM
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.