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Clinical and Developmental Immunology
Volume 2013, Article ID 859761, 7 pages
http://dx.doi.org/10.1155/2013/859761
Review Article

Late and Chronic Antibody-Mediated Rejection: Main Barrier to Long Term Graft Survival

1Department of Renal Transplantation, The Third Affiliated Hospital, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou 510630, China
2Department of Liver Transplantation, The Third Affiliated Hospital, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou 510630, China

Received 27 June 2013; Accepted 3 September 2013

Academic Editor: Xian Li

Copyright © 2013 Qiquan Sun and Yang Yang. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Antibody-mediated rejection (AMR) is an important cause of graft loss after organ transplantation. It is caused by anti-donor-specific antibodies especially anti-HLA antibodies. C4d had been regarded as a diagnosis marker for AMR. Although most early AMR episodes can be successfully controlled or reversed, late and chronic AMR remains the leading cause of late graft loss. The strategies which work in early AMR have limited effect on late/chronic episodes. Here, we reviewed the lines of evidence that late/chronic AMR is the leading cause of late graft loss, characteristics of late AMR, and current strategies in managing late/chronic AMR. More effort should be put on the management of late/chronic AMR to make a better long term graft survival.