Antibody-mediated rejection

被引:21
作者
Akalin, Enver
Watschinger, Bruno
机构
[1] Mt Sinai Sch Med, Div Renal, New York, NY 10029 USA
[2] Mt Sinai Sch Med, Recanti Miller Transplantat Inst, New York, NY 10029 USA
[3] Med Univ Vienna, Dept Med 3, Div Renal, Vienna, Austria
关键词
anti-HLA antibody; kidney transplantation; sensitization; humoral rejection;
D O I
10.1016/j.semnephrol.2007.05.001
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Summary: The introduction of both complement 4d (C4d) staining in renal allograft biopsies and sensitive methods to detect anti-human leukocyte antigen antibodies, such as single antigen bead flow assays, into tissue-typing techniques have shown the importance of antibody-mediated alloimmune response in kidney transplantation. The use of these sensitive methods, combined with the increased number of transplants in highly sensitized patients with donor-specific antibodies, or patients receiving desensitization protocols, have increased the awareness and thus the incidence of acute antibody-mediated rejection. Chronic rejection also can be mediated through alloantibodies, and the term chronic antibody-mediated rejection recently was proposed. In this review article we summarize the current knowledge of the role of alloantibodies in transplantation, the diagnosis and treatment of acute and chronic antibody-mediated rejection, and their effect on graft function and outcome. © 2007 Elsevier Inc. All rights reserved.
引用
收藏
页码:393 / 407
页数:15
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