C1q-Binding Antibodies in Kidney Transplantation

Antibody-mediated injury is now recognized as a major cause of renal-allograft injury and loss. Antibodies can cause vascular injury that is acute or chronic as well as abrupt or progressive loss of function. The diagnosis of antibody-mediated injury is based most critically on the detection of donor-specific antibodies, along with evidence of complement activation in the graft and signs of tissue injury and inflammation.1 Methods of detecting antibodies have become increasingly sensitive and precise, and the repertoire of potentially pathogenic antibodies includes a broad range of anti–class I HLA antibodies and anti–class II HLA antibodies, as well as non-HLA antibodies. . . .