{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:27:51Z","timestamp":1793039271146,"version":"4.5.0"},"reference-count":64,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T00:00:00Z","timestamp":1663286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>De novo<\/jats:italic> donor-specific HLA antibodies (dnDSA) are key factors in the diagnosis of antibody-mediated rejection (ABMR) and related to graft loss.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study was designed to evaluate the natural course of dnDSA in graft function and kidney allograft survival and to assess the impact of mean fluorescence intensity (MFI) evolution as detected by annual Luminex<jats:sup>\u00ae<\/jats:sup> screening. All 400 kidney transplant recipients with 731 dnDSA against the last graft (01\/03\/2000-31\/05\/2021) were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During 8.3 years of follow-up, ABMR occurred in 24.8% and graft loss in 33.3% of the cases, especially in patients with class I and II dnDSA, and those with multiple dnDSA. We observed frequent changes in MFI with 5-year allograft survivals post-dnDSA of 74.0% in patients with MFI reduction \u2265 50%, 62.4% with fluctuating MFI (MFI reduction \u2265 50% and doubling), and 52.7% with doubling MFI (log-rank <jats:italic>p<\/jats:italic> &amp;lt; 0.001). Interestingly, dnDSA in 168 (24.3%) cases became negative at some point during follow-up, and 38\/400 (9.5%) patients became stable negative, which was associated with better graft survival. Multivariable analysis revealed the importance of MFI evolution and rejection, while class and number of dnDSA were not contributors in this model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In summary, we provide an in-depth analysis of the natural course of dnDSA after kidney transplantation, first evidence for the impact of MFI evolution on graft outcomes, and describe a relevant number of patients with a stable disappearance of dnDSA, related to better allograft survival.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.943502","type":"journal-article","created":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T06:12:04Z","timestamp":1663308724000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":29,"title":["The natural history of de novo donor-specific HLA antibodies after kidney transplantation"],"prefix":"10.3389","volume":"9","author":[{"given":"Covadonga","family":"L\u00f3pez del Moral","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaiyin","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Naik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilgin","family":"Osmanodja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aylin","family":"Akifova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Lachmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Stauch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Hergovits","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mira","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friederike","family":"Bachmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Halleck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Schrezenmeier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danilo","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klemens","family":"Budde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"964","DOI":"10.1016\/j.kint.2018.05.018","article-title":"Analyses of the short- and long-term graft survival after kidney transplantation in Europe between 1986 and 2015.","volume":"94","author":"Coemans","year":"2018","journal-title":"Kidney Int."},{"key":"B2","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1016\/j.kint.2018.08.005","article-title":"Long-term renal allograft survival: a quiet revolution.","volume":"94","author":"Jardine","year":"2018","journal-title":"Kidney Int."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2824","DOI":"10.1111\/ajt.16463","article-title":"Long-term kidney transplant graft survival-Making progress when most needed.","volume":"21","author":"Poggio","year":"2021","journal-title":"Am J Transplant."},{"key":"B4","doi-asserted-by":"publisher","first-page":"729","DOI":"10.1056\/NEJMra2014530","article-title":"Long-Term survival after kidney transplantation.","volume":"385","author":"Hariharan","year":"2021","journal-title":"N Engl J Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1681\/ASN.2020081215","article-title":"Exploring the complexity of death-censored kidney allograft failure.","volume":"32","author":"Mayrdorfer","year":"2021","journal-title":"J Am Soc Nephrol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1111\/j.1600-6143.2008.02519.x","article-title":"Identifying specific causes of kidney allograft loss.","volume":"9","author":"El-Zoghby","year":"2009","journal-title":"Am J Transplant."},{"key":"B7","doi-asserted-by":"publisher","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 antibody-mediated rejection and nonadherence.","volume":"12","author":"Sellar\u00e9s","year":"2012","journal-title":"Am J Transplant."},{"key":"B8","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1097\/TP.0000000000000183","article-title":"The histology of kidney transplant failure: a long-term follow-up study.","volume":"98","author":"Naesens","year":"2014","journal-title":"Transplantation."},{"key":"B9","doi-asserted-by":"publisher","first-page":"e0162278","DOI":"10.1371\/journal.pone.0162278","article-title":"The spectrum of renal allograft failure.","volume":"11","author":"Chand","year":"2016","journal-title":"PLoS One."},{"key":"B10","doi-asserted-by":"publisher","first-page":"2557","DOI":"10.1097\/TP.0000000000003192","article-title":"Assessing the complex causes of kidney allograft loss.","volume":"104","author":"Van Loon","year":"2020","journal-title":"Transplantation."},{"key":"B11","doi-asserted-by":"publisher","first-page":"2318","DOI":"10.1111\/ajt.15898","article-title":"The Banff 2019 kidney meeting report (I): updates on and clarification of criteria for T cell- and antibody-mediated rejection.","volume":"20","author":"Loupy","year":"2020","journal-title":"Am J Transplant."},{"key":"B12","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1016\/j.kint.2021.04.044","article-title":"The emerging field of non\u2013human leukocyte antigen antibodies in transplant medicine and beyond.","volume":"100","author":"Lefaucheur","year":"2021","journal-title":"Kidney Int."},{"key":"B13","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/j.kint.2019.01.030","article-title":"Non-HLA agonistic anti-angiotensin II type 1 receptor antibodies induce a distinctive phenotype of antibody-mediated rejection in kidney transplant recipients.","volume":"96","author":"Lefaucheur","year":"2019","journal-title":"Kidney Int."},{"key":"B14","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1681\/ASN.2016070756","article-title":"The emerging importance of Non-HLA autoantibodies in kidney transplant complications.","volume":"28","author":"Cardinal","year":"2017","journal-title":"J Am Soc Nephrol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"e768","DOI":"10.1097\/TXD.0000000000001215","article-title":"Increased autoantibodies against Ro\/SS-A, CENP-B, and La\/SS-B in patients with kidney allograft antibody-mediated rejection.","volume":"7","author":"Clotet-Freixas","year":"2021","journal-title":"Transplant Direct."},{"key":"B16","first-page":"171","article-title":"Donor-specific HLA antibodies in chronic renal allograft rejection: a prospective trial with a four-year follow-up.","author":"Lachman","year":"2006","journal-title":"Clin Transpl."},{"key":"B17","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1111\/j.1600-6143.2006.01711.x","article-title":"Extremely high association between appearance of HLA antibodies and failure of kidney grafts in a five-year longitudinal study.","volume":"4","author":"Mao","year":"2007","journal-title":"Am J Transplant."},{"key":"B18","first-page":"171","article-title":"Detailed examination of HLA antibody development on renal allograft failure and function.","volume":"2008","author":"Zhu","year":"2008","journal-title":"Clin Transpl."},{"key":"B19","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1111\/ajt.14625","article-title":"The Banff 2017 kidney meeting report: revised diagnostic criteria for chronic active T cell-mediated rejection, antibody-mediated rejection, and prospects for integrative endpoints for next-generation clinical trials.","volume":"18","author":"Haas","year":"2018","journal-title":"Am J Transplant."},{"key":"B20","doi-asserted-by":"publisher","first-page":"2413","DOI":"10.1111\/ajt.16474","article-title":"Revisiting the changes in the Banff classification for antibody- mediated rejection after kidney transplantation.","volume":"21","author":"Callemeyn","year":"2021","journal-title":"Am J Transplant."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1912","DOI":"10.1681\/ASN.2016070797","article-title":"Antibody-Mediated rejection due to preexisting versus de novo donor-specific antibodies in kidney allograft recipients.","volume":"28","author":"Aubert","year":"2017","journal-title":"J Am Soc Nephrol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.2215\/CJN.13401118","article-title":"Preformed donor-specific HLA antibodies in living and deceased donor transplantation: a multicenter study.","volume":"14","author":"Ziemann","year":"2019","journal-title":"Clin J Am Soc Nephrol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"182","DOI":"10.2215\/CJN.00700117","article-title":"Donor-Specific antibodies in kidney transplant recipients.","volume":"13","author":"Zhang","year":"2018","journal-title":"Clin J Am Soc Nephrol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1053\/j.ajkd.2015.03.033","article-title":"Humoral immune response and allograft function in kidney transplantation.","volume":"66","author":"Filippone","year":"2015","journal-title":"Am J Kidney Dis."},{"key":"B25","doi-asserted-by":"publisher","first-page":"3355","DOI":"10.1111\/j.1600-6143.2012.04251.x","article-title":"Posttransplant de novo donor-specific hla antibodies identify pediatric kidney recipients at risk for late antibody-mediated rejection.","volume":"12","author":"Ginevri","year":"2012","journal-title":"Am J Transplant."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1505","DOI":"10.1097\/TP.0b013e3181a44206","article-title":"Anti-human leukocyte antigen and donor-specific antibodies detected by luminex posttransplant serve as biomarkers for chronic rejection of renal allografts.","volume":"87","author":"Lachmann","year":"2009","journal-title":"Transplantation."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1084","DOI":"10.1111\/j.1432-2277.2011.01312.x","article-title":"Long-term follow up for anti-HLA donor specific antibodies postrenal transplantation: high immunogenicity of HLA class II graft molecules.","volume":"24","author":"Ntokou","year":"2011","journal-title":"Transpl Int."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1157","DOI":"10.1111\/j.1600-6143.2012.04013.x","article-title":"Evolution and clinical pathologic correlations of de novo donor specific HLA antibody post kidney transplant.","volume":"12","author":"Wiebe","year":"2012","journal-title":"Am J Transplant."},{"key":"B29","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1097\/TP.0b013e31827d62e3","article-title":"Incidence and impact of de novo donor-specific alloantibody in primary renal allografts.","volume":"95","author":"Everly","year":"2013","journal-title":"Transplantation."},{"key":"B30","doi-asserted-by":"publisher","first-page":"e14170","DOI":"10.1111\/ctr.14170","article-title":"Screening strategy for de novo donor-specific HLA antibodies beyond the first year after kidney transplantation: personalized or \u201cone size fits all\u201d?","volume":"35","author":"Cun","year":"2021","journal-title":"Clin Transplant."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1097\/TP.0b013e3182139da1","article-title":"Inferior kidney allograft outcomes in patients with de novo donor-specific antibodies are due to acute rejection episodes.","volume":"91","author":"Cooper","year":"2011","journal-title":"Transplantation."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1604","DOI":"10.1111\/ajt.14752","article-title":"Sensitization in transplantation: assessment of risk (STAR) 2017 working group meeting report.","volume":"18","author":"Tambur","year":"2018","journal-title":"Am J Transplant."},{"key":"B33","doi-asserted-by":"publisher","first-page":"3076","DOI":"10.1111\/ajt.14393","article-title":"Donor-recipient matching based on predicted indirectly recognizable HLA epitopes independently predicts the incidence of de novo donor-specific HLA antibodies following renal transplantation.","volume":"17","author":"Lachmann","year":"2017","journal-title":"Am J Transplant."},{"key":"B34","doi-asserted-by":"publisher","first-page":"631246","DOI":"10.3389\/fimmu.2021.631246","article-title":"Can PIRCHE-II matching outmatch traditional HLA matching?","volume":"12","author":"Unterrainer","year":"2021","journal-title":"Front Immunol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"2000","DOI":"10.3389\/fimmu.2020.02000","article-title":"Analysis of T and B cell epitopes to predict the risk of de novo donor-specific antibody (DSA) production after kidney transplantation: a two-center retrospective cohort study.","volume":"11","author":"Sakamoto","year":"2020","journal-title":"Front Immunol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"2833","DOI":"10.1111\/ajt.16563","article-title":"Preformed T cell alloimmunity and HLA eplet mismatch to guide immunosuppression minimization with tacrolimus monotherapy in kidney transplantation: results of the CELLIMIN trial.","volume":"21","author":"Bestard","year":"2021","journal-title":"Am J Transplant."},{"key":"B37","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1097\/TP.0b013e3181b11b72","article-title":"HLA-specific antibodies developed in the first year posttransplant are predictive of chronic rejection and renal graft loss.","volume":"88","author":"Lee","year":"2009","journal-title":"Transplantation."},{"key":"B38","doi-asserted-by":"publisher","first-page":"113","DOI":"10.5500\/wjt.v3.i4.113","article-title":"Essential concept of transplant immunology for clinical practice.","volume":"3","author":"Kumbala","year":"2013","journal-title":"World J Transplant."},{"key":"B39","doi-asserted-by":"publisher","first-page":"2188","DOI":"10.1016\/j.transproceed.2021.07.011","article-title":"Clinical outcome of kidney transplant patients on the allograft function, loss, effects of HLA-DQB1-DSA +, and Graft Survival.","volume":"53","author":"Cunha","year":"2021","journal-title":"Transplant Proc."},{"key":"B40","doi-asserted-by":"publisher","first-page":"2193","DOI":"10.1681\/ASN.2020010019","article-title":"Eplet mismatch load and de novo occurrence of donor-specific Anti-HLA antibodies, rejection, and graft failure after kidney transplantation: an observational cohort study.","volume":"31","author":"Senev","year":"2020","journal-title":"J Am Soc Nephrol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"2652","DOI":"10.1111\/ajt.15937","article-title":"Sensitization in transplantation: assessment of risk (STAR) 2019 working group meeting report.","volume":"20","author":"Tambur","year":"2020","journal-title":"Am J Transplant."},{"key":"B42","first-page":"359","article-title":"Clinical significance of post kidney transplant de novo DSA in otherwise stable grafts.","volume":"2011","author":"Cooper","year":"2011","journal-title":"Clin Transpl."},{"key":"B43","doi-asserted-by":"publisher","first-page":"101430","DOI":"10.1016\/j.trim.2021.101430","article-title":"De novo donor-specific HLA antibodies reduce graft survival rates and increase the risk of kidney transplant rejection: a single-center retrospective study.","volume":"68","author":"Liu","year":"2021","journal-title":"Transpl Immunol."},{"key":"B44","doi-asserted-by":"publisher","first-page":"2421","DOI":"10.1111\/ajt.13295","article-title":"Assessing antibody strength: comparison of MFI, C1q, and titer information.","volume":"15","author":"Tambur","year":"2015","journal-title":"Am J Transplant."},{"key":"B45","doi-asserted-by":"publisher","first-page":"S23","DOI":"10.1097\/TP.0000000000001817","article-title":"HLA diagnostics: evaluating DSA strength by titration.","volume":"102","author":"Tambur","year":"2018","journal-title":"Transplantation."},{"key":"B46","doi-asserted-by":"publisher","first-page":"1976","DOI":"10.1097\/TP.0000000000000672","article-title":"Association of kidney graft loss with de novo produced donor-specific and non-donor-specific HLA antibodies detected by single antigen testing.","volume":"99","author":"S\u00fcsal","year":"2015","journal-title":"Transplantation."},{"key":"B47","doi-asserted-by":"publisher","first-page":"1859","DOI":"10.1111\/ajt.12287","article-title":"Comprehensive assessment and standardization of solid phase multiplex-bead arrays for the detection of antibodies to HLA.","volume":"13","author":"Reed","year":"2013","journal-title":"Am J Transplant."},{"key":"B48","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1016\/j.humimm.2009.04.001","article-title":"Naturally occurring interference in Luminex assays for HLA-specific antibodies: characteristics and resolution.","volume":"70","author":"Zachary","year":"2009","journal-title":"Hum Immunol."},{"key":"B49","doi-asserted-by":"publisher","first-page":"e61971","DOI":"10.3791\/61971","article-title":"TBase - an integrated electronic health record and research database for kidney transplant recipients.","volume":"170","author":"Schmidt","year":"2021","journal-title":"J Vis Exp."},{"key":"B50","doi-asserted-by":"publisher","first-page":"666319","DOI":"10.3389\/fmed.2021.666319","article-title":"Clinicopathologic features and risk factors of proteinuria in transplant glomerulopathy.","volume":"8","author":"Zhang","year":"2021","journal-title":"Front Med."},{"key":"B51","doi-asserted-by":"publisher","first-page":"199","DOI":"10.3390\/jcm11010199","article-title":"Poor long-term renal allograft survival in patients with chronic antibody-mediated rejection, irrespective of treatment-a single center retrospective study.","volume":"11","author":"Wu","year":"2021","journal-title":"J Clin Med."},{"key":"B52","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/tan.14521","article-title":"Determination of unacceptable HLA antigen mismatches in kidney transplant recipients.","volume":"100","author":"Ziemann","year":"2021","journal-title":"HLA."},{"key":"B53","doi-asserted-by":"publisher","first-page":"1313","DOI":"10.1016\/j.humimm.2013.06.025","article-title":"Six-locus high resolution HLA haplotype frequencies derived from mixed-resolution DNA typing for the entire US donor registry.","volume":"74","author":"Gragert","year":"2013","journal-title":"Hum Immunol."},{"key":"B54","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1016\/j.humimm.2019.07.275","article-title":"Next-generation sequencing reveals new information about HLA allele and haplotype diversity in a large European American population - Table S13, S14.","volume":"80","author":"Creary","year":"2019","journal-title":"Hum Immunol."},{"key":"B55","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1111\/tan.13378","article-title":"Common and well-documented HLA alleles of German stem cell donors by haplotype frequency estimation.","volume":"92","author":"Eberhard","year":"2018","journal-title":"HLA."},{"key":"B56","year":"2020"},{"key":"B57","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1111\/tri.13525","article-title":"Predictors of graft survival at diagnosis of antibody-mediated renal allograft rejection: a retrospective single-center cohort study.","volume":"33","author":"Waiser","year":"2020","journal-title":"Transpl Int."},{"key":"B58","doi-asserted-by":"publisher","first-page":"3212","DOI":"10.1111\/ajt.13838","article-title":"De novo donor-specific human leukocyte antigen antibody screening in kidney transplant recipients after the first year posttransplantation: a medical decision analysis.","volume":"16","author":"Kiberd","year":"2016","journal-title":"Am J Transplant."},{"key":"B59","doi-asserted-by":"publisher","first-page":"1126","DOI":"10.1111\/j.1600-6143.2010.03053.x","article-title":"T cell-mediated rejection of kidney transplants: a personal viewpoint.","volume":"10","author":"Halloran","year":"2010","journal-title":"Am J Transplant."},{"key":"B60","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1111\/ajt.16883","article-title":"The negative impact of T cell\u2013mediated rejection on renal allograft survival in the modern era.","volume":"22","author":"Rampersad","year":"2021","journal-title":"Am J Transplant."},{"key":"B61","doi-asserted-by":"publisher","first-page":"2499","DOI":"10.1111\/ajt.15860","article-title":"Evidence for the alloimmune basis and prognostic significance of Borderline T cell\u2013mediated rejection.","volume":"20","author":"Wiebe","year":"2020","journal-title":"Am J Transplant."},{"key":"B62","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1016\/j.kint.2021.06.026","article-title":"Significance of HLA-DQ in kidney transplantation: time to reevaluate human leukocyte antigen-matching priorities to improve transplant outcomes? An expert review and recommendations.","volume":"100","author":"Tambur","year":"2021","journal-title":"Kidney Int."},{"key":"B63","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1097\/00000658-199110000-00016","article-title":"Immunomodulation of kidney and heart transplants by anti-idiotypic antibodies.","volume":"4","author":"Hardy","year":"1991","journal-title":"Ann Surg."},{"key":"B64","doi-asserted-by":"publisher","first-page":"1490","DOI":"10.1097\/01.TP.0000060252.57111.AC","article-title":"Beneficial effect of plasmapheresis and intravenous immunoglobulin on renal allograft survival of patients with acute humoral rejection.","volume":"9","author":"Rocha","year":"2003","journal-title":"Transplantation."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.943502\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T06:12:10Z","timestamp":1663308730000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.943502\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,16]]},"references-count":64,"alternative-id":["10.3389\/fmed.2022.943502"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.943502","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,16]]},"article-number":"943502"}}