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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

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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
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
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:
DateEvent
1 December 2015Published
13 December 2014Available
11 November 2014Accepted
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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