Antibody-mediated rejection across solid organ transplants: manifestations, mechanisms, and therapies
Nicole M. Valenzuela and Elaine F. Reed
UCLA Immunogenetics Center, Department of Pathology and Laboratory Medicine, UCLA, Los Angeles, California, USA.
Address correspondence to: Elaine F. Reed, UCLA Immunogenetics Center, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, 1000 Veteran Avenue, Los Angeles, California 90095, USA. Phone: 310.794.4943; Email: ereed@mednet.ucla.edu.
Find articles by Valenzuela, N. in: JCI | PubMed | Google Scholar
UCLA Immunogenetics Center, Department of Pathology and Laboratory Medicine, UCLA, Los Angeles, California, USA.
Address correspondence to: Elaine F. Reed, UCLA Immunogenetics Center, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, 1000 Veteran Avenue, Los Angeles, California 90095, USA. Phone: 310.794.4943; Email: ereed@mednet.ucla.edu.
Find articles by Reed, E. in: JCI | PubMed | Google Scholar
First published June 12, 2017 - More info
J Clin Invest. 2017;127(7):2492–2504. doi:10.1172/JCI90597.
Copyright © 2017, American Society for Clinical Investigation
Solid organ transplantation is a curative therapy for hundreds of thousands of patients with end-stage organ failure. However, long-term outcomes have not improved, and nearly half of transplant recipients will lose their allografts by 10 years after transplant. One of the major challenges facing clinical transplantation is antibody-mediated rejection (AMR) caused by anti-donor HLA antibodies. AMR is highly associated with graft loss, but unfortunately there are few efficacious therapies to prevent and reverse AMR. This Review describes the clinical and histological manifestations of AMR, and discusses the immunopathological mechanisms contributing to antibody-mediated allograft injury as well as current and emerging therapies.
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