Acute and chronic antibody-mediated rejection in pediatric kidney transplantation

被引：14
作者：
Pape, Lars [1 ,4 ]
Becker, Jan U. [2 ]
Immenschuh, Stephan [3 ,4 ]
Ahlenstiel, Thurid [1 ,4 ]
机构：
[1] Hannover Med Sch, Dept Pediat Nephrol, D-30655 Hannover, Germany
[2] Hannover Med Sch, Inst Pathol, D-30655 Hannover, Germany
[3] Hannover Med Sch, Inst Transfus Med, D-30655 Hannover, Germany
[4] Integrated Res & Treatment Ctr Transplantat, Hannover, Germany
来源：
PEDIATRIC NEPHROLOGY | 2015年 / 30卷 / 03期
关键词：
Antibody-mediated rejection; Donor-specific antibodies; Banff classification; Immunoadsorption; Rituximab; DONOR-SPECIFIC ANTIBODIES; NON-HLA ANTIBODIES; LEUKOCYTE ANTIGEN ANTIBODIES; SOLID-ORGAN TRANSPLANTATION; RENAL-TRANSPLANTATION; ALLOGRAFT-REJECTION; GRAFT LOSS; CLINICAL-RELEVANCE; RECIPIENTS; GLOMERULOPATHY;
D O I：
10.1007/s00467-014-2851-2
中图分类号：
R72 [儿科学];
学科分类号：
100202 ;
摘要：
Acute antibody-mediated rejection is a diagnostic challenge in renal transplantation medicine. However, it is an important diagnosis to make, since chronic antibody-mediated rejection (CAMR) is the main cause of long-term graft loss. Antibody-mediated rejection is diagnosed by detecting donor-specific antibodies (DSAs) in the blood in combination with observing typical histomorphological signs in kidney biopsy, as described in the Banff classification. Therapy is based on the removal of DSAs by administering intravenous immunoglobulins (IVIGs), plasmapheresis, or immunoadsorption. Reoccurrence of antibodies is diminished by the use of rituximab, increased immunosuppression, and in some cases additional experimental substances. A combination of these techniques has been shown to be successful in the majority of cases of acute and chronic antibody-mediated rejection. Routine DSA monitoring is warranted for early detection of antibody-mediated rejection.
引用
收藏
页码：417 / 424
页数：8
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