{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:54:23Z","timestamp":1790837663575,"version":"4.1.0"},"reference-count":75,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:p>\n                    Donor-specific antibodies have become an established biomarker predicting antibody-mediated rejection. Antibody-mediated rejection is the leading cause of graft loss after kidney transplant. There are several phenotypes of antibody-mediated rejection along post-transplant course that are determined by the timing and extent of humoral response and the various characteristics of donor-specific antibodies, such as antigen classes, specificity, antibody strength, IgG subclasses, and complement binding capacity. Preformed donor-specific antibodies in sensitized patients can trigger hyperacute rejection, accelerated acute rejection, and early acute antibody-mediated rejection.\n                    <jats:italic toggle=\"yes\">De novo<\/jats:italic>\n                    donor-specific antibodies are associated with late acute antibody-mediated rejection, chronic antibody-mediated rejection, and transplant glomerulopathy. The pathogeneses of antibody-mediated rejection include not only complement-dependent cytotoxicity, but also complement-independent pathways of antibody-mediated cellular cytotoxicity and direct endothelial activation and proliferation. The novel assay for complement binding capacity has improved our ability to predict antibody-mediated rejection phenotypes. C1q binding donor-specific antibodies are closely associated with acute antibody-mediated rejection, more severe graft injuries, and early graft failure, whereas C1q nonbinding donor-specific antibodies correlate with subclinical or chronic antibody-mediated rejection and late graft loss. IgG subclasses have various abilities to activate complement and recruit effector cells through the Fc receptor. Complement binding IgG3 donor-specific antibodies are frequently associated with acute antibody-mediated rejection and severe graft injury, whereas noncomplement binding IgG4 donor-specific antibodies are more correlated with subclinical or chronic antibody-mediated rejection and transplant glomerulopathy. Our in-depth knowledge of complex characteristics of donor-specific antibodies can stratify the patient\u2019s immunologic risk, can predict distinct phenotypes of antibody-mediated rejection, and hopefully, will guide our clinical practice to improve the transplant outcomes.\n                  <\/jats:p>","DOI":"10.2215\/cjn.00700117","type":"journal-article","created":{"date-parts":[[2017,4,26]],"date-time":"2017-04-26T20:20:17Z","timestamp":1493238017000},"page":"182-192","source":"Crossref","is-referenced-by-count":274,"title":["Donor-Specific Antibodies in Kidney Transplant Recipients"],"prefix":"10.2215","volume":"13","author":[{"given":"Rubin","family":"Zhang","sequence":"first","affiliation":[{"name":"Section of Nephrology, Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,4,26]]},"reference":[{"key":"B1-20230813","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1038\/ki.2013.300","article-title":"Antibody-mediated rejection, T cell-mediated rejection, and the injury-repair response: New insights from the Genome Canada studies of kidney transplant biopsies.","volume":"85","author":"Halloran","year":"2014","journal-title":"Kidney Int"},{"key":"B2-20230813","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1681\/ASN.2015070781","article-title":"Effect of immunosuppressive drugs on humoral allosensitization after kidney transplant.","volume":"27","author":"Thaunat","year":"2016","journal-title":"J Am Soc Nephrol"},{"key":"B3-20230813","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1111\/j.1600-6143.2011.03840.x","article-title":"Understanding the causes of kidney transplant failure: The dominant role of 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