Antibody-mediated rejection of solid-organ allografts

Abstract

To the editor: the comprehensive review article by Loupy and Lefaucheur (Sept. 20 issue)1 on antibody-mediated rejection describes major advances in understanding the pathophysiological process and diagnosis of antibody-mediated rejection, but successful treatment is still limited to the acute forms of antibody-mediated rejection.2 Allograft loss eventually occurs in the majority of patients in whom true pathogenic donor-specific anti-HLA antibodies develop.3 This is frustrating for both clinicians and patients because even treatments administered at early stages of the disease are not effective. It is quite obvious that the best strategy to minimize the risk of donor-specific antibodies is to improve the level of HLA matching between the donor and recipient.4 This point was omitted in the article.