Chris Wiebe1, Peter Nickerson. 1. Department of Medicine and Immunology, University of Manitoba, Winnipeg, Manitoba, Canada.
Abstract
PURPOSE OF REVIEW: To summarize the evidence supporting the negative impact of de novo donor-specific antibodies (dnDSA) in renal transplantation and to describe the natural history associated with the development of dnDSA. RECENT FINDINGS: Recent studies have increased our appreciation of the risk factors that predispose to dnDSA while illuminating how these risk factors may relate to the pathophysiology underlying its development. In addition, details regarding the natural history of dnDSA are now available in the context of the different clinical pathologic phenotypes that occur in the patients in whom it develops. Common pitfalls in defining and monitoring dnDSA, when understood, may provide some explanation for the heterogeneity in published studies. SUMMARY: Recognizing that dnDSA is a major cause of late graft loss, and, more importantly, is detectable in many cases long before dysfunction or graft loss occurs, identifies an opportunity to intervene and change the outcome for the patient.
PURPOSE OF REVIEW: To summarize the evidence supporting the negative impact of de novo donor-specific antibodies (dnDSA) in renal transplantation and to describe the natural history associated with the development of dnDSA. RECENT FINDINGS: Recent studies have increased our appreciation of the risk factors that predispose to dnDSA while illuminating how these risk factors may relate to the pathophysiology underlying its development. In addition, details regarding the natural history of dnDSA are now available in the context of the different clinical pathologic phenotypes that occur in the patients in whom it develops. Common pitfalls in defining and monitoring dnDSA, when understood, may provide some explanation for the heterogeneity in published studies. SUMMARY: Recognizing that dnDSA is a major cause of late graft loss, and, more importantly, is detectable in many cases long before dysfunction or graft loss occurs, identifies an opportunity to intervene and change the outcome for the patient.
Authors: Rodrigo Benedetti Gassen; Thiago J Borges; María José Pérez-Sáez; Hengcheng Zhang; Ayman Al Jurdi; Laura Llinàs-Mallol; Bruno Aoyama; Maurício Lima; Julio Pascual; Peter T Sage; Naoka Murakami; Leonardo V Riella Journal: Am J Transplant Date: 2022-04-15 Impact factor: 9.369
Authors: Martin Schiemann; Elisabeth Puchhammer-Stöckl; Farsad Eskandary; Philip Kohlbeck; Susanne Rasoul-Rockenschaub; Andreas Heilos; Nicolas Kozakowski; Irene Görzer; Željko Kikić; Harald Herkner; Georg A Böhmig; Gregor Bond Journal: Transplantation Date: 2017-02 Impact factor: 4.939