Early Versus Late Acute Antibody-Mediated Rejection in Renal Transplant Recipients

Abstract

Compared with early aABMR, late aABMR had inferior graft survival and was characterized by young age, frequent nonadherence, or suboptimal immunosuppression and de novo donor-specific antibodies.

Late antibody-mediated rejection after heart transplantation: Mortality, graft function, and fulminant cardiac allograft vasculopathy

“…Similar complications were described after treatment of AMR in kidney transplant recipients. 6 Immunosuppressive treatment of AMR is based on antibody removal and therapy to suppress further synthesis; it is challenging, and no consensus guidelines exist. As emphasized by a recent survey, the treatment of AMR is heterogeneous across hospitals.…”

“…4,5 Late AMR may be associated with a worse prognosis compared with early AMR. 6,7 However, little is known concerning late AMR after heart transplantation. In a previous cohort of 15 patients, Hodges et al 4 showed that late AMR was associated with poor short-term prognosis despite aggressive immunosuppressive therapies.…”

Utility of HLA Antibody Testing in Kidney Transplantation

“…Late AMR is associated with chronic pathology and worse dysfunction at the time of diagnosis, mixed cellular and humoral features, and subsequently, lower treatment response rates, [132][133][134] but it is notable that DSA MFI does not reliably further stratify those individuals who will respond to treatment from those who will do not. 133 Indeed, in one study, those who responded to treatment had higher antibody level as estimated by MFI than nonresponders.…”

Comparison of Different Methods of Anti-Hla Antibodies Detection in Diagnosis of Antibody-Mediated Renal Allograft Rejection

“…Однако важнейшим фактором, определяющим клиническую картину и течение отторжения, является комплаентность па-циента и адекватность иммуносупрессивной тера-пии в целом. Так, по данным Dörje с соавторами, клинически манифестные формы острого гумо-рального отторжения были ассоциированы имен-но с этими факторами [27]. В нашем исследовании преобладали случаи вялотекущего/субклиническо-го течения ОГО, и значительно чаще процесс выяв-лялся на стадии ХОТ (39 vs 85 пациентов).…”