Antibody-Mediated Rejection: Diagnosis and Treatment

Laura P Halverson; Ramsey R Hachem

doi:10.1016/j.ccm.2022.10.008

Antibody-Mediated Rejection: Diagnosis and Treatment

Clin Chest Med. 2023 Mar;44(1):95-103. doi: 10.1016/j.ccm.2022.10.008.

Authors

Laura P Halverson¹, Ramsey R Hachem²

Affiliations

¹ Division of Pulmonary & Critical Care, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8052, Saint Louis, MO 63108, USA. Electronic address: laura.halverson@wustl.edu.
² Division of Pulmonary & Critical Care, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8052, Saint Louis, MO 63108, USA.

Abstract

Antibody-mediated rejection (AMR) is a form of lung allograft rejection that is emerging as an important risk factor for chronic lung allograft dysfunction and decreased long-term survival. In this review, we provide a brief overview of our current understanding of its pathophysiology with an emphasis on donor-specific antibodies before moving on to focus on the current diagnostic criteria and treatment strategies. Our goal is to discuss the limitations of our current knowledge and explore how novel diagnostic and therapeutic options aim to improve outcomes through earlier definitive diagnosis and preemptive targeted treatment.

Keywords: Antibody-mediated rejection; Chronic lung allograft survival; Donor-specific antibodies; Lung transplantation.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Antibodies
Graft Rejection / diagnosis
Graft Rejection / prevention & control
Humans
Lung
Lung Transplantation*
Thorax
Transplantation, Homologous

Substances

Antibodies

Grants and funding

R34 HL138186/HL/NHLBI NIH HHS/United States