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- Title
Understanding Antibody-Mediated Rejection of Organ Transplants: Mechanisms, Morphology, Molecular Patterns, and Personalized Precision Diagnosis.
- Authors
Sis, Banu
- Abstract
Transplantation is a life-saving treatment for patients with end-stage organ failure. While modern drugs have significantly improved 1-year transplant survival, the rate of organ transplant failure after the first year remains substantial. The lack of improvement in long-term transplant survival can be explained, at least partially, by the production of antibodies against donor antigens, which causes organ transplant damage (rejection) and failure. Clinical studies show that antibody-mediated rejection is a major problem in organ transplantation because of its negative impact on transplant outcomes and function, with no effective treatments. Microvascular endothelium is the main target of injury in antibody-mediated rejection of organ transplants. This group previously observed upregulation of several endothelial genes in kidney transplant biopsies from patients with alloantibody, indicating active antibody-mediated rejection and poor graft survival. Furthermore, endothelial molecular signals discovered a previously unknown clinical phenotype: C4d-negative antibody-mediated rejection. This article reviews the current understanding of effector mechanisms of antibody-mediated rejection, its morphological and molecular patterns in allograft tissues and current insensitive diagnostic criteria, and discusses a new diagnostic approach that will bring pathologists closer to precision diagnosis.
- Subjects
TRANSPLANTATION of organs, tissues, etc.; LIFESAVING; MULTIPLE organ failure; VASCULAR endothelium; GRAFT rejection; MORPHOLOGY
- Publication
Canadian Journal of Pathology, 2013, Vol 5, Issue 1, p27
- ISSN
1918-915X
- Publication type
Article