Diagnosis, Treatment, and Outcomes of Antibody-Mediated Rejection in Kidney Transplantation

Abstract

Antibody mediated rejection remains an important barrier to optimal long-term outcomes after kidney transplantation. Donor specific antibody, while not the formidable barrier to transplantation it once was, remains a major risk factor for antibody mediated rejection and its consequences of premature graft failure. Recent advances in understanding of the cellular and molecular mechanisms of antibody production and antibody-mediated injury have led to refinements in diagnostic techniques, and have paved the way for the development of novel therapies to treat rejection and prolong allograft function. The purpose of this chapter is to review the current level at which we understand the pathophysiology of antibody mediated rejection, describe the current diagnostic criteria for antibody mediated rejection, and discuss available and emerging treatments as well as their outcomes.