Chronic Renal Allograft Dysfunction Antibody-Mediated: An Update - European Medical Journal

Chronic Renal Allograft Dysfunction Antibody-Mediated: An Update

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*Maurizio Salvadori, Elisabetta Bertoni

No potential conflict of interest.

EMJ Nephrol. ;1[1]:91-99. DOI/10.33590/emjnephrol/10312924.
Chronic rejection, antibodies, complement, donor-specific antibodies, renal transplantation.

Each article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.


This paper reviews the most important studies on chronic antibody-mediated rejection (cABMR), which is an important cause of late graft dysfunction after renal transplantation. Several antibodies seem to be responsible for chronic rejection; new techniques have allowed us to identify these antibodies in circulation. The pathogenetic role of the antibodies generally includes the complement pathway, but may also be complement-independent. This paper also examines the pathogenesis of chronic endothelial lesions, as well as the histopathological aspects. Antibodies responsible for chronic rejection may preexist before transplantation or may develop after transplantation. The possible therapeutic approaches are poor and principally based on early identification and desensitisation techniques. New B cell targeting drugs are aimed at an improved control of the relevant condition.

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