Immunological Aspect on Late Allograft Dysfunction

摘要

Organ transplantation is a well-accepted treatment for patients with end-stage organ failure. Despite continued improvement in short-term graft survival, late allograft dysfunction remains a significant problem in the clinic, especially in kidney transplant patients. Many factors contribute to late graft dysfunction, and among them immunological factors are the leading cause of late grafts loss. In this special issue, we have solicited a set of interesting papers addressing some aspects of this important topic in the field.Here we focused on antibody-mediated rejection (AMR), as AMR is emerging as a major barrier to long-term graft survival, and the donor-specific antibodies are directly involved in AMR. The paper by Q. Sun and Y. Yang provides a comprehensive overview of the characteristics of AMR, both in acute rejection and late chronic rejection, and the current strategies in managing AMR. S. Lionaki et al. provide us with an excellent review on the incidence and clinical significance of de novo donor specific antibodies (DSA) after renal transplantation. It is well recognized that transplant glomerulopathy is a very special entity of late AMR, and Dr. W. Hanf from Australia discussed the effect of donor HLA antibodies on endothelium in transplant settings. These three review papers provide an extensive overview on antibody reactivity and its correlation with late graft injury.