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World J Transplant. Mar 24, 2014; 4(1): 1-17
Published online Mar 24, 2014. doi: 10.5500/wjt.v4.i1.1
Published online Mar 24, 2014. doi: 10.5500/wjt.v4.i1.1
Impact of donor-specific antibodies on the outcomes of kidney graft: Pathophysiology, clinical, therapy
Maurizio Salvadori, Elisabetta Bertoni, Department of Renal Transplantation, Careggi University Hospital, 50139 Florence, Italy
Author contributions: Salvadori M and Bertoni E contributed equally to the concept, acquisition of data, drafting of the article, revisions and final approvals.
Correspondence to: Maurizio Salvadori, MD, Department of Transplantation, Careggi University Hospital, viale Pieraccini 18, 50139 Florence, Italy. maurizio.salvadori1@gmail.com
Telephone: +39-55-597151 Fax: +39-55-597151
Received: November 1, 2013
Revised: January 23, 2014
Accepted: March 3, 2014
Published online: March 24, 2014
Processing time: 103 Days and 19.2 Hours
Revised: January 23, 2014
Accepted: March 3, 2014
Published online: March 24, 2014
Processing time: 103 Days and 19.2 Hours
Core Tip
Core tip: Clear evidence exists that shows that donor-specific-HLA antibodies (DSAs) are the primary players in the acute and chronic deterioration of graft. The emergence of sensitive techniques that detect DSAs, together with advances in the assessment of graft pathology, has enabled an improved understanding of antibody-mediated graft injury. Acute and chronic antibody-mediated rejection conditions have changed the nomenclature during recent Banff conferences and have enabled the dismissal of older terminologies, such as chronic allograft nephropathy. Therapies aimed at B cells and plasma cells and that control complement activation will be extremely important for improving long-term outcomes in kidney transplantations.