title: Antibody-mediated rejection following renal transplantation.
abstract: 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.
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, USA. ksureshk@wpahs.org
authors.forename: Kalathil K
authors.initials: KK
authors.lastname: Sureshkumar
authors.forename: Sabiha M
authors.initials: SM
authors.lastname: Hussain
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Carpenter
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Sandroni
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Marcus
mesh_terms: D000906:Antibodies / Q000276:immunology*; D006084:Graft Rejection / Q000276:immunology* / Q000628:therapy; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D012307:Risk Factors; D014181:Transplantation Immunology
chemical_list: D000906:Antibodies