Background
Antibody Mediated Rejection (AMR)1,2
• Rejection that occurs due to antibodies against donor-specific antigen (DSA)
– Antibodies activate complement system
– Leads to cell death and tissue necrosis
• Risk Factors
– Pregnancy
– Blood transfusions
– Prior transplantation
• Types of AMR
– Hyperacute
• Occurs within minutes of graft transplantation causing death of the graft
• Due to pre-formed antibodies present in high titers
• Rarely occurs now due to universal cross-matching
– Acute
• Occurs within a few days of transplantation causing graft dysfunction
• Due to pre-formed antibodies or antibodies that develop de novo after transplantation
– Chronic
• Occurs during the years following transplantation