Current opinion in organ transplantation
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Curr Opin Organ Transplant · Oct 2016
ReviewDonor-specific antibodies and antibody-mediated rejection in vascularized composite allotransplantation.
The presence of donor-specific antibodies (DSA) increases the risk of graft failure. Although DSA characteristics, human leukocyte antigen class specificity, mean fluorescence intensity and immunoglobulin G subclasses, and their impact on the graft are quite well studied in solid organ transplants, very little information is known about their impact on vascularized composite allotransplantation (VCA). The aim of this review is to highlight recent publications regarding occurrence and effects of DSA, their follow-up and treatment in the field of VCA. ⋯ The functional outcome of reconstructive transplantation has clearly exceeded the results achieved with conventional surgical techniques. The recipients' immune response, particularly development of DSA and the long-term adherence, which is probably associated with the occurrence of chronic rejection, remain a challenge.