Pre-formed DSA and kidney allograft outcomes

Donor-specific antibodies (DSAs) directed against HLA antigens are central to the development of antibody-mediated rejection and chronic allograft vasculopathy, the leading causes of long-term transplant failure. DSAs can be preexisting (preformed) or arise de novo (dnDSA) following transplantation. Preformed DSAs occur through previous exposure to alloantigens after blood transfusion, pregnancy or prior transplant. Because preformed DSAs significantly increase the risk of antibody-mediated rejection (ABMR), organs expressing the target antigens of the DSAs are avoided if possible. Using solid-phase, single antigen [...]