title: [Current aspects of acute humoral rejection].
abstract: Acute clinical antibody-mediated rejection is currently defined by (1), an acute renal failure occurring during the first months following transplantation, (2), at least a microcirculation inflammation (glomerulitis and peritubular capillaritis) on kidney biopsy and (3), the presence in peripheral blood of donor specific antibodies, mostly anti-human leukocyte antigen (HLA) antibodies. The prognosis of this rejection is scored using the severity of vascular lesions and the positivity of C4d on peritubular capillaries. Recently, a subclinical variety of antibody-mediated rejection was recognized as an entity because, as the clinical rejection, it leads to chronic antibody-mediated rejection, currently the most frequent cause of graft loss. The description of these various aspects of antibody-mediated rejection allowed a better understanding of its pathophyiology that may lead in a near future to a more specific treatment.
authors.affiliation: Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France. Electronic address: christophe.legendre@nck.aphp.fr.
authors.forename: Christophe
authors.initials: C
authors.lastname: Legendre
authors.affiliation: Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Loupy
authors.affiliation: Service d'anatomie pathologique, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Rabant
authors.affiliation: Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Aubert
authors.affiliation: Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France.
authors.forename: Clémentine
authors.initials: C
authors.lastname: Rabaté
authors.affiliation: Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France.
authors.forename: Marianne
authors.initials: M
authors.lastname: Delville
authors.affiliation: Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Tinel
authors.affiliation: Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France.
authors.forename: Lucile
authors.initials: L
authors.lastname: Amrouche
authors.affiliation: Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France.
authors.forename: Frank
authors.initials: F
authors.lastname: Martinez
authors.affiliation: Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France.
authors.forename: Renaud
authors.initials: R
authors.lastname: Snanoudj
authors.affiliation: Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France.
authors.forename: Lynda
authors.initials: L
authors.lastname: Bererhi
authors.affiliation: Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Scemla
authors.affiliation: Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France.
authors.forename: Rébecca
authors.initials: R
authors.lastname: Sberro-Soussan
authors.affiliation: Service d'anatomie pathologique, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Duong
authors.affiliation: Laboratoire d'histocompatibilité, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Suberbielle
authors.affiliation: Service de néphrologie - transplantation rénale adulte, hôpital Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris cedex 15, France; Université Paris Descartes, 75743 Paris cedex 15, France.
authors.forename: Dany
authors.initials: D
authors.lastname: Anglicheau
mesh_terms: D000208:Acute Disease; D018951:Antigens, CD20 / Q000276:immunology; D015935:Complement C4b / Q000032:analysis; D004730:Endothelium, Vascular / Q000276:immunology / Q000473:pathology; D006084:Graft Rejection / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007518:Isoantibodies / Q000097:blood / Q000276:immunology; D007668:Kidney / Q000098:blood supply / Q000473:pathology; D016030:Kidney Transplantation; D008833:Microcirculation; D010446:Peptide Fragments / Q000032:analysis; D012079:Renal Circulation
chemical_list: D018951:Antigens, CD20; D006680:HLA Antigens; D007166:Immunosuppressive Agents; D007518:Isoantibodies; D010446:Peptide Fragments; D015935:Complement C4b; C032261:complement C4d
keywords: Acute humoral rejection; Anti-CD20 antibodies; Anti-HLA antibodies; Anticorps anti-CD20; Anticorps anti-HLA; Rejection; Rejet; Rejet aigu humoral