{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T16:16:12Z","timestamp":1794327372202,"version":"4.9.0"},"reference-count":97,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2020,5,1]],"date-time":"2020-05-01T00:00:00Z","timestamp":1588291200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:p>With the development of modern solid-phase assays to detect anti-HLA antibodies and a more precise histological classification, the diagnosis of antibody-mediated rejection (AMR) has become more common and is a major cause of kidney graft loss. Currently, there are no approved therapies and treatment guidelines are based on low-level evidence. The number of prospective randomized trials for the treatment of AMR is small, and the lack of an accepted common standard for care has been an impediment to the development of new therapies. To help alleviate this, The Transplantation Society convened a meeting of international experts to develop a consensus as to what is appropriate treatment for active and chronic active AMR. The aim was to reach a consensus for standard of care treatment against which new therapies could be evaluated. At the meeting, the underlying biology of AMR, the criteria for diagnosis, the clinical phenotypes, and outcomes were discussed. The evidence for different treatments was reviewed, and a consensus for what is acceptable standard of care for the treatment of active and chronic active AMR was presented. While it was agreed that the aims of treatment are to preserve renal function, reduce histological injury, and reduce the titer of donor-specific antibody, there was no conclusive evidence to support any specific therapy. As a result, the treatment recommendations are largely based on expert opinion. It is acknowledged that properly conducted and powered clinical trials of biologically plausible agents are urgently needed to improve patient outcomes.<\/jats:p>","DOI":"10.1097\/tp.0000000000003095","type":"journal-article","created":{"date-parts":[[2019,12,31]],"date-time":"2019-12-31T15:48:04Z","timestamp":1577807284000},"page":"911-922","source":"Crossref","is-referenced-by-count":342,"title":["Recommended Treatment for Antibody-mediated Rejection After Kidney Transplantation: The 2019 Expert Consensus From the Transplantion Society Working Group"],"prefix":"10.1097","volume":"104","author":[{"given":"Carrie A.","family":"Schinstock","sequence":"first","affiliation":[{"name":"Mayo Clinic William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roslyn B.","family":"Mannon","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klemens","family":"Budde","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Medical Intensive Care, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita S.","family":"Chong","sequence":"additional","affiliation":[{"name":"Section of Transplantation, Department of Surgery, The University of Chicago, Chicago, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Haas","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"Knechtle","sequence":"additional","affiliation":[{"name":"Duke Transplant Center, Department of Surgery, Duke University School of Medicine, Durham, NC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Lefaucheur","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, Department of Transplantation, Saint Louis Hospital, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Montgomery","sequence":"additional","affiliation":[{"name":"NYU Langone Transplant Institute, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Nickerson","sequence":"additional","affiliation":[{"name":"Transplant Immunology Laboratory, Shared Health and Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan G.","family":"Tullius","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery and Transplant Surgery Research Laboratory, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curie","family":"Ahn","sequence":"additional","affiliation":[{"name":"Transplantation Center, Seoul National University Hospital, Seoul, Korea."},{"name":"Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Medhat","family":"Askar","sequence":"additional","affiliation":[{"name":"Baylor University Medical Center, Transplant Immunology, Dallas, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Crespo","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital del Mar and Institute Hospital del Mar for Medical Research, Barcelona, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Chadban","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandy","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California San Francisco, San Francisco, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley C.","family":"Jordan","sequence":"additional","affiliation":[{"name":"Comprehensive Transplant Center, Cedars-Sinai Medical Center, West Hollywood, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwan","family":"Man","sequence":"additional","affiliation":[{"name":"Department of Surgery, The University of Hong Kong, Hong Kong, People's Republic of China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Mengel","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall E.","family":"Morris","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine, Stanford, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inish","family":"O\u2019Doherty","sequence":"additional","affiliation":[{"name":"Critical Path Institute, Tucson, AZ."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binnaz H.","family":"Ozdemir","sequence":"additional","affiliation":[{"name":"Department of Pathology, Baskent University, School of Medicine, Ankara, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Seron","sequence":"additional","affiliation":[{"name":"Nephrology Department, Hospital Vall d\u2019Hebron, Autonomous University of Barcelona, Catalonia, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anat R.","family":"Tambur","sequence":"additional","affiliation":[{"name":"Comprehensive Transplant Center, Northwestern University, Chicago, 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