{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T22:26:06Z","timestamp":1787610366880,"version":"build-2736575974"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005624","name":"Medizinischen Hochschule Hannover","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005624","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontierspartnerships.org"],"crossmark-restriction":true},"short-container-title":["Transpl. Int."],"abstract":"<jats:p>Antibody-mediated rejection (ABMR) is the leading cause of long-term graft loss in pediatric kidney transplantation (KTx). While donor-specific HLA antibodies are established contributors, emerging evidence suggests a role for non-HLA antibodies in ABMR pathogenesis. In this descriptive study, we analyzed 60 non-HLA antibodies in 77 pediatric KTx recipients using serum samples collected pre-transplant, post-transplant, and at ABMR diagnosis. During a median follow-up of 4.83\u00a0years, 29.8% developed ABMR, with a median onset of 3.67\u00a0years. Non-HLA antibody presence prior to KTx was not influenced by pre-transplant dialysis; over half of the patients already had &amp;gt;15 positive non-HLA antibodies. The cumulative antibody profile remained stable 1\u20132\u00a0years post-KTx, with no association between late ABMR and antibody strength or breadth. However, ACTIN (higher risk) and CGB5 (lower risk) at 1\u20132\u00a0years post-KTx, as well as SNRPB2 pre-transplant, were significantly associated with ABMR (p &amp;lt; 0.05). IL-21 levels increased in controls over time (p &amp;lt; 0.05), although driven by five patients with notably high levels. Our findings support a potential involvement of non-HLA antibodies in pediatric ABMR. Nevertheless, larger studies are needed to validate the predictive value of individual non-HLA antibodies for clinical application.<\/jats:p>","DOI":"10.3389\/ti.2025.14463","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T16:33:56Z","timestamp":1755534836000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Development of Non-HLA Antibodies and Their Association With Antibody-Mediated Rejection in Pediatric Kidney Transplant 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