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Transplantation

Antibody-mediated vascular rejection of transplanted kidneys

Nature Reviews Nephrology volume 9, page 63 (2013)Cite this article

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Humoral mechanisms are increasingly recognized as a cause of graft loss in recipients of HLA-incompatible kidney transplants; however, vascular rejection of kidney allografts has traditionally been thought of as a process mediated by T cells. A new study published in The Lancet now shows that vascular rejection can in fact be associated with anti-HLA antibodies. The researchers believe that recognition of this distinct phenotype could lead to the development of new treatment strategies and to the rescue of many failing kidney allografts.

The researchers retrospectively examined biospy samples from patients who had received a kidney transplant at Necker Hospital and Saint Louis Hospital, Paris, France between 1998 and 2008. Of 2,079 transplant recipients, 302 were identified as having acute biopsy-proven rejection. In addition to extensive graft phenotyping, the researchers tested all patients for donor-specific antibodies from stored sera. “A critical point was that we wanted to get rid of any preconceived conceptions of rejection diagnoses. We therefore used a mathematical assessment of rejection patterns, which included all information regarding graft lesions, C4d status in allograft biopsy samples, and donor-specific anti-HLA antibody status,” says Loupy.

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References

ORIGINAL RESEARCH PAPER

  1. Lefaucheur, C. et al. Antibody-mediated vascular rejection of kidney allografts: a population-based study. Lancet doi:10.1016/S0140-6736(12)61265-3

FURTHER READING

  1. Nankivell, B. J. Antibody-mediated vascular rejection: relation to causation. Lancet doi:10.1016/S0140-6736(12)61577-3

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Authors
  1. Susan J. Allison
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Allison, S. Antibody-mediated vascular rejection of transplanted kidneys. Nat Rev Nephrol 9, 63 (2013). https://doi.org/10.1038/nrneph.2012.266

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  • DOI: https://doi.org/10.1038/nrneph.2012.266

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