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Updated: Apr 29, 2026

Mouse Kidney Transplantation: Models of Allograft Rejection
Published on: October 11, 2014
Acute and chronic antibody-mediated rejection in pediatric kidney transplantation
Lars Pape1, Jan U Becker, Stephan Immenschuh
1Department of Pediatric Nephrology, Hannover Medical School, Carl-Neuberg-Straße 1, 30655, Hannover, Germany, larspape@t-online.de.
Abstract:
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.
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