ANTIBODY-MEDIATED REJECTION IN KIDNEY TRANSPLANT RECIPIENTS

This paper provides a review of the significant problem of humoral, or antibody-mediated rejection,in kidney transplantation. the main cause of antibody-mediated rejection is donor-specificanti-hla antibodies. patients with anti-hla antibodies are called sensitised patients. the outcomeof humoral rejection is unfavourable: graft dysfunction and failure have been frequent fromthe early post-transplant period and are continuing. international laboratories and clinics offersensitive and accurate methods to determine antibodies before and after kidney transplantation,but the methods are not always successful in recognition of sensitised patients. for diagnostics ofhumoral rejection the important issue is detecting complement breakdown deposition (c4d) inperitubular capillaries during immunohistological examination. on the one hand, their presence ischaracteristic for humoral rejection, but on the other hand, they can occur without any clinicalchanges or can remain undetected during severe humoral rejection. current methods of prevention,diagnostics and treatment of humoral rejection are discussed. difficulties of evaluation ofchronic antibody-mediated injury are particularly highlighted.