There is no evidence of acute antibody-mediated rejection
according to the 2015 Banff classification (g0, ptc0, and no C4d deposit by immunofluorescence (not shown)).
Chadban, "The treatment of acute antibody-mediated rejection
in kidney transplant recipients--a systematic review," Transplantation, vol.
Desvaux et al., "C1q binding is not an independent risk factor for kidney allograft loss after an acute antibody-mediated rejection episode: a retrospective cohort study," Transplant International, vol.
Harford et al., "Elevated pre-transplantation soluble BAFF is associated with an increased risk of acute antibody-mediated rejection," Transplantation Journal, vol.
Complement-binding DSA target class 1 HLA on endothelial cells, activate the classic complement cascade, and deliver complement-dependent cytotoxicity in acute antibody-mediated rejection. Complement-nonbinding DSA recruit innate immune cells (NK cells, macrophages, and neutrophils) through Fc receptors and lead to antibody-dependent cellular toxicity.
Girnita et al., "Early and late acute antibody-mediated rejection differ immunologically and in response to proteasome inhibition," Transplantation, vol.
In the past, a positive preoperative XM guaranteed cancellation of the transplant However, it was found that the transplanted kidneys of recipients who had a negative preoperative XM, but developed antibodies after the transplant due to a delayed response (acute antibody-mediated rejection), could be rescued (rescue therapy) by removing the offending antibodies from their blood using plasmapheresis.
(1995), in a series of 50 renal transplants, had five develop anti-HLA antibodies that led to acute antibody-mediated rejection in the first week after transplant.
Postoperatively, 10 of the 20 patients developed acute antibody-mediated rejection. In all cases, the acute antibody-mediated rejection was very responsive to additional plasmapheresis/CMV-HG therapy.
Segev et al., "Subclinical acute antibody-mediated rejection in positive crossmatch renal allografts," American Journal of Transplantation, vol.
Loupy et al., "C1 inhibitor in acute antibody-mediated rejection nonresponsive to conventional therapy in kidney transplant recipients: a pilot study," American Journal of Transplantation, vol.
Buchler et al., "One-year results of the effects of rituximab on acute antibody-mediated rejection
in renal transplantation: RITUX ERAH, a multicenter doubleblind randomized placebo-controlled trial," Transplantation, vol.