Antibody-mediated rejection following renal transplantation.
Antibody-mediated rejection (AMR) accounts for 20-30% of all acute rejection episodes following renal transplantation. AMR is generally less responsive to conventional anti-rejection therapy, resulting in poor allograft survival. Introduction of C4d immunostaining of renal allograft biopsies and the demonstration of donor-specific antibodies in the recipients have increased our ability to diagnose AMR. Therapeutic options are evolving and include plasmapheresis, intravenous immunoglobulin, immunoadsorption and rituximab, together with intensification of immunosuppression with a tacrolimus/mycophenolate mofetil combination. Future studies might further define optimal therapeutic approach in renal transplant recipients presenting with AMR.
Sureshkumar
Kalathil K
KK
Division of Nephrology and Hypertension, Department of Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, USA. ksureshk@wpahs.org
Hussain
Sabiha M
SM
Carpenter
Barbara J
BJ
Sandroni
Stephen E
SE
Marcus
Richard J
RJ
D000906:Antibodies / Q000276:immunology*; D006084:Graft Rejection / Q000276:immunology* / Q000628:therapy; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D012307:Risk Factors; D014181:Transplantation Immunology
D000906:Antibodies