Within 2 months after the diagnosis JQ1 order of BL1 and 4 months after BL2, rejection appeared, thus the patients in BL1 tended to experience rejection earlier. Statistically, graft survival did not significantly differ between the BL1 and BL2 groups (P = 0.44), and events of acute rejection in patients with BL had no detrimental effect on graft survival up to the late examination (P = 0.69) (Fig. 2). Results of the second biopsy for all BL patients who
underwent that procedure showed 13 categorized as BL1 (32.5%), 3 as BL2 (7.5%), 8 with ATMR Ia (20.0%), 2 with ATMR Ib (5.0%), 1 with chronic T-cell mediated rejection (CTMR) (2.5%), 1 chronic antibody mediated rejection (CAMR) (2.5%), 4 with normal findings (NF) (10.0%), and other findings in 8 (20.0%). Furthermore, MK-8669 clinical trial when divided into BL1 and BL2, the 21 BL1 patients led to 6 as BL1 (28.5%), 1 as BL2 (4.8%), 6 with ATMR Ia (28.5%), 1 ATMR Ib (4.8%), 1 with CAMR (4.8%), 2 with NF (9.5%), and 8 others (19.0%), while the 19 with BL2 led to 7 as BL1 (36.8%), 2 as BL2 (10.5%), 2 with ATMR Ia (10.5%), 1 with ATMR Ib (5.3%), 1 with CTMR (5.3%), 2 NF (10.5%), and 4 others (21.0%). We also analysed predictive factors associated with rejection onset by using univariate logistic
regression. No significant difference was observed between B1 and B2 in regard to rejection development (odds ratio (OR) = 1.16, confidence index (CI): 0.31–4.28, P = 0.816). There were also no significant factors relevant Janus kinase (JAK) to rejection among the other factors (human leukocyte antigen mismatch (OR = 0.99, CI: 0.59–1.64, P = 0.97); spousal transplantation (OR = 0.90, CI: 0.20–3.66, P = 0.89);
ABO incompatible (OR = 0.99, CI: 0.01–1.75, P = 0.18); use of tacrolimus (OR = 0.56, CI: 0.14–2.07, P = 0.38); donor age (OR = 1.01, CI: 0.93–1.11, P = 0.75); recipient age (OR = 1.02, CI: 0.97–1.07, P = 0.41); male (OR = 1.62, CI: 0.38–8.65, P = 0.52). There is no clear consensus regarding clinical outcome after development of BL or the treatment strategy for it, while appropriate clinical management for patients showing such changes in biopsy findings also remains controversial. Moreso et al. reported a significantly higher incidence of clinical acute rejection in patients with BL and the same for graft survival rate in patients with BL as compared with those with normal findings. The incidence rate of acute rejection after BL was 48% in that report, while we found a rate of 35% in the present. BL cases have a high probability of rejection onset and should be treated, however, it does not have an influence on rate of survival. With such a background in mind, it is not surprising that contradicting reports recommend and do not recommend treatment. Since Saad et al.