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KMID : 0361120130270010006
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Korean Journal of Transplantation
2013 Volume.27 No. 1 p.6 ~ p.14
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Update on the Treatment of Acute and Chronic Antibody-mediated Rejection
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Park Kwan-Tae
Jung Cheol-Woong
Kim Myung-Kyu
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Abstract
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Antibody-mediated rejection (AMR) by preformed and/or de novo human leukocyte antigen alloantibodies is a leading cause of early and late allograft loss. In this review, we describe strategic approaches to various forms of AMR in clinical settings that are not based on pathologic classification, which is controversial for atypical AMR (C4d-, DSA-, subclinical etc.). For acute AMR, a variety of modalities like plasmapheresis, intravenous immunoglobulin, and anti-CD20 antibodies have been utilized singly, or in combination, with variable results; however, no established treatment for chronic AMR is known. Significant research efforts are being made for developing new and novel therapies. Improvements in clinical outcomes can be expected from studies evaluating innovative therapeutic concepts, such as proteasome inhibition or complement-blocking agents.
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KEYWORD
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Transplantation, Rejection, Antibodies
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