Preformed and De Novo Donor Specific Antibodies in Visceral Transplantation: Long-Term Outcome With Special Reference to the Liver

Impact of IgG3 Subclass and C1q-Fixing Donor-Specific HLA Alloantibodies on Rejection and Survival in Liver Transplantation

“…Moreover, antibody-mediated rejection (AMR) is now recognized as a cause of allograft loss in all solid organ transplants despite significant differences in incidence and outcome (6)(7)(8)(9)(10)(11). Historically, it has been recognized that the liver is relatively resistant to the pathologic effects of DSA compared to other solid organs (12)(13)(14)(15).…”

The Current State of Intestine Transplantation: Indications, Techniques, Outcomes and Challenges

“…Although the frequent use of induction therapy has markedly decreased the rate of early severe acute rejection, the consequences of severe rejection are considerably higher than other solid organs, that is, a 50% mortality rate (38). While traditionally treatment for acute rejection with bolus steroids or anti-lymphocyte therapy has been aimed to control the T cell-mediated response to the allograft, antibody-mediated mechanisms in intestine rejection have achieved increasing attention (39). Although donor-specific antibody (DSA) formation in the serum of the recipient associated with graft injury is suggestive of antibodymediated intestine rejection (similar to other solid organ transplants), the histologic findings of antibody-mediated rejection (AMR) in the intestine are not yet well-defined due to nonspecific C4d staining in mucosal biopsies and the absence of graft mesenteric arterial structures in the typical intestine biopsy (40 …”

Antibody-mediated rejection across solid organ transplants: manifestations, mechanisms, and therapies

“…The presence of circulating DSAs is required for the diagnosis of AMR in renal (30), pancreas (32), liver (31), and Unknown; lack of consensus: yes (194), no (195) Recommended (35) Possibly; capillary dilatation and congestion (196) Adherent inflammatory cells in vessels; more severe rejection with transmural inflammation (195,196) Not well defined because of nonspecific C4d staining and paucity of vessels in biopsies …”