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Antibody-incompatible kidney transplantation in 2015 and beyond
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Higgins, Rob, Daga, Sunil and Mitchell, Daniel A. (2015) Antibody-incompatible kidney transplantation in 2015 and beyond. Nephrology, Dialysis, Transplantation, 30 (12). pp. 1972-1978. doi:10.1093/ndt/gfu375
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Official URL: http://dx.doi.org/10.1093/ndt/gfu375
Abstract
Rejection caused by donor-specific antibodies (principally ABO and HLA antibodies) has become one of the major barriers to successful long-term transplantation. This review focuses on clinical outcomes in antibody-incompatible transplantation, the current state of the science underpinning clinical observations, and how these may be translated into further novel therapies. The clinical outcomes for allografts facing donor-specific antibodies are at present determined largely by the use of agents developed in the 20th century for the treatment of T-lymphocyte-mediated cellular rejection, such as interleukin-2 agents and anti-thymocyte globulin. These treatments are partially effective, because acute antibody-mediated rejection is mediated to a considerable extent by T lymphocytes. However these treatments are essentially ineffective in chronic antibody-mediated rejection. Future therapies for the prevention and treatment of antibody-mediated rejection are likely to fall into the categories of those that reduce antibody production, extracorporeal antibody removal and disruption of the effector arms of antibody-mediated tissue damage.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RD Surgery | ||||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016) Faculty of Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Kidneys -- Transplantation, Transplantation immunology | ||||||||
| Journal or Publication Title: | Nephrology, Dialysis, Transplantation | ||||||||
| Publisher: | Oxford University Press | ||||||||
| ISSN: | 0931-0509 | ||||||||
| Official Date: | 1 December 2015 | ||||||||
| Dates: |
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| Volume: | 30 | ||||||||
| Number: | 12 | ||||||||
| Number of Pages: | 7 | ||||||||
| Page Range: | pp. 1972-1978 | ||||||||
| DOI: | 10.1093/ndt/gfu375 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Open Access |
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