Non-invasive screening for sub-clinical antibody-mediated rejection as a new tool for indication of kidney allograft biopsy

摘要

Antibody-mediated rejection (ABMR) is nowadays the major problemfor long-term kidney allograft survival. ABMR frequently takes acontinuous and fluctuating course. It often occurs sub-clinically, and abnormalserum creatinine levels or the detection of proteinuria is onlydetectable at stages with already advanced graft injury. Frequentfollow-up controls to uncover the rise of known pre-transplant donorspecificantibodies (DSA) or their de novo formation, that might triggerdiagnostic biopsies for detection of earlier stages of graft injury, or theimplementation of protocol biopsies are not always possible in transplantcentres. However, a timely treatment of ABMR would enhance significantlygraft outcome [1–4].