Impact of donor-specific antibodies on the outcomes of kidney graft: Pathophysiology, clinical, therapy

Table 2 Anti-antibodies main drugs to date in use and mechanism of action

Steps	Cells or mechanisms involved	Drugs	Mechanism of action
Exposure to antigen	B Cells	Rituximab ivig	Binds CD20 on B cells and mediates cell lysis Multiple B cell apoptosis, decrease in B-cell proliferation
Secretion of alloantibodies	Plasma cells; antibodies	Bortezomib	Decrease donor-specific alloantibody production Mechanical removal of alloantibodies
		Plasma- exchange ivig	Multiple B cell apoptosis, decrease in B-cell proliferation
Binding of antibodies to the graft	Complement activation	Eculizumab	Blocks cleavage of terminal complement C5 and halts the process of complement-mediated cell destruction