Acute Antibody-Mediated Rejection in Kidney Transplant Recipients

Abstract Antibody-mediated rejection has now been recognized as one of the most important causes of graft loss. Transplantation across HLA barriers and non-adherence can result in acute antibody-mediated rejection, which is associated with particularly worse graft outcomes. New technologies, includi...

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Bibliographic Details
Published in:Transplantation reviews (Philadelphia, Pa.) Pa.), 2017-01, Vol.31 (1), p.47-54
Main Authors: Davis, Scott, Cooper, James E
Format: Article
Language:English
Subjects:
Acute Disease
Female
Graft Rejection - immunology
Graft Rejection - prevention & control
HLA Antigens - immunology
Humans
Immunosuppression - methods
Kidney Failure, Chronic - diagnosis
Kidney Failure, Chronic - surgery
Kidney Transplantation - adverse effects
Kidney Transplantation - methods
Male
Preoperative Care - methods
Primary Prevention - methods
Prognosis
Risk Assessment
Surgery
Transplant Recipients
Transplantation Immunology - physiology
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Summary:Abstract Antibody-mediated rejection has now been recognized as one of the most important causes of graft loss. Transplantation across HLA barriers and non-adherence can result in acute antibody-mediated rejection, which is associated with particularly worse graft outcomes. New technologies, including genomic studies and assays to detect and define donor-specific antibodies, have provided important insights into the pathophysiology and diagnosis of acute antibody-mediated rejection but have engendered many questions about the clinical application of these tests in the prognosis and prevention of this protean disease process. In this article, we review the pathophysiology of acute antibody-mediated rejection, the evolving diagnostic criteria, and specific challenges related to its prognosis, treatment, and prevention.
ISSN:0955-470X
1557-9816
DOI:10.1016/j.trre.2016.10.004