Antibody-mediated rejection of renal allograft and the update Banff classification 2013

Czech version

Authors: Eva Honsová
Authors‘ workplace: Pracoviště klinické a transplantační patologie, Transplantcentrum IKEM
Published in: Čes.-slov. Patol., 51, 2015, No. 3, p. 116-119
Category: Reviews Article

Overview

The view on the role of donor-specific antibodies in organ transplantation has been changed during the last several decades. Today, it is considered that the majority of cases of the late renal allograft dysfunction and loss are caused by the presence of donor-specific antibodies to HLA antigens. The real breakthrough in the diagnosis of antibody-mediated rejection was represented by the discovery of C4d, which enabled the determination of the diagnostic criteria of acute and later chronic antibody-mediated rejection. Although detection of C4d has been the cornerstone in the diagnosis of antibody-mediated rejection for over 10 years, it has become clear that some cases with similar morphological and clinical features do not have detectable C4d.

Outcomes of key studies concerning presence of donor specific antibodies and morphological features in the graft biopsy samples resulted in the modification of Banff classification of 2013, which includes integrating C4d negative antibody-mediated rejection and also that acute vascular rejection (v1, v2) can be a part of the antibody-mediated rejection.

Keywords:
kidney allograft – antibody-mediated rejection – T-cell mediated rejection

Sources

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Anatomical pathology Forensic medical examiner Toxicology

Tubulointerstitial rejection of renal allografts

Infections after kidney transplantation

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Article was published in

Czecho-Slovak Pathology

2015 Issue 3