Open AccessRituximab as monotherapy for the treatment of chronic active antibody‐mediated rejection after kidney transplantation
Author(s) -
Muller Yannick D.,
Ghaleb Nseir,
Rotman Samuel,
Vionnet Julien,
Halfon Matthieu,
Catana Emmanuelle,
Golshayan Déla,
Venetz JeanPierre,
Aubert Vincent,
Pascual Manuel
Publication year - 2018
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.13111
Subject(s) - medicine , rituximab , kidney transplantation , transplantation , nephrology , donor specific antibodies , antibody , immunology , kidney disease , oncology
Chronic active antibody-mediated rejection (caAMR) is a major cause of allograft loss after kidney transplantation (1). The BANFF 2013 classification redefined caAMR by the presence of donor-specific anti-HLA antibodies (DSA) together with immuno-histopathological evidence for active vascular lesions of the endothelium (C4d deposits, glomerulitis, peritubular capillaritis) as well as evidence of chronic tissue injury (transplant glomerulopathy, peritubular capillary basement membrane multilayering or arterial intimal fibrosis) (2,3). Humoral immunity, detected by the presence of DSA, and B cells are considered pivotal in the development of caAMR. Gosset et al. showed that circulating DSA are responsible for accelerated allograft fibrosis independently of acute AMR (1). This article is protected by copyright. All rights reserved.