Author(s): Silva,Rita M. ; Leal,Rita ; Marques,Maria G. ; Rodrigues,Luís ; Santos,Lídia ; Romãozinho,Catarina ; Figueiredo,Arnaldo ; Alves,Rui
Date: 2023
Origin: SciELO Portugal
Subject(s): Graft Rejection/immunology; Histocompatibility/immunology; HLA Antigens/immunology; Isoantibodies/immunology; Kidney Transplantation
ABSTRACT The diagnosis of antibody-mediated rejection has become more common and represents a major cause of kidney graft loss. The ideal treatment remains unknown, with little evidence supporting the use of a specific therapy. The definition of antibody-mediated rejection is based on serologic (presence and/or development of donor-specific antibodies) and histologic (evidence of acute tissue injury with C4d deposition or other signs of antibody interaction with the vascular endothelium) criteria. Antibody-mediated rejection without donor‐specific antibodies is a subcategory with a defying diagnosis. This particularly entity is increasingly being reported as an important cause of allograft dysfunction in kidney transplantation. We describe the case of a kidney transplant recipient with a low immunological risk and delayed graft function due to an antibody-mediated rejection with negative donor-specific antibodies.
