title: Not All Antibodies Are Created Equal: Factors That Influence Antibody Mediated Rejection.
abstract: Consistent with Dr. Paul Terasaki's "humoral theory of rejection" numerous studies have shown that HLA antibodies can cause acute and chronic antibody mediated rejection (AMR) and decreased graft survival. New evidence also supports a role for antibodies to non-HLA antigens in AMR and allograft injury. Despite the remarkable efforts by leaders in the field who pioneered single antigen bead technology for detection of donor specific antibodies, a considerable amount of work is still needed to better define the antibody attributes that are associated with AMR pathology. This review highlights what is currently known about the clinical context of pre and posttransplant antibodies, antibody characteristics that influence AMR, and the paths after donor specific antibody production (no rejection, subclinical rejection, and clinical dysfunction with AMR).
authors.affiliation: Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
authors.forename: Carrie L
authors.initials: CL
authors.lastname: Butler
authors.affiliation: Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Valenzuela
authors.affiliation: Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Thomas
authors.affiliation: Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
authors.forename: Elaine F
authors.identifier: 0000-0002-3524-545X
authors.initials: EF
authors.lastname: Reed
mesh_terms: D006084:Graft Rejection / Q000276:immunology*; D006085:Graft Survival / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D007155:Immunologic Factors / Q000276:immunology*; D007518:Isoantibodies / Q000276:immunology*; D016030:Kidney Transplantation; D014019:Tissue Donors; D014184:Transplantation, Homologous
chemical_list: D006680:HLA Antigens; D007155:Immunologic Factors; D007518:Isoantibodies