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Transcriptional Changes in Kidney Allografts with Histology of Antibody-Mediated Rejection without Anti-HLA Donor-Specific Antibodies

from Journal of the American Society of Nephrology

Transcriptional Changes in Kidney Allografts with Histology of Antibody-Mediated Rejection without Anti-HLA Donor-Specific Antibodies Journal of the American Society of Nephrology Donor-specific anti-HLA antibodies (HLA-DSAs) are often not detectable in serum of kidney allograft recipients whose biopsies display histology of antibody-mediated rejection (ABMR), which creates uncertainty in clinical decision making. The authors show that ABMR histology associates with a distinct transcriptional profile that is independent of the presence of HLA-DSAs, although the presence of HLA-DSAs is also an independent risk factor for graft failure after ABMR histology. However, molecular assessment of allograft biopsy specimens does not elucidate the underlying cause of ABMR histology, and these findings indicate that therapeutic decisions should not be based solely on the histologic and molecular presentation. READ MORE

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