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The presence of specific antibodies against human leukocyte antigen (HLA-DSA) is considered the main cause of antibody-mediated rejection (ABMR). However there is a subgroup of patients with ABMR histological characteristics but without detectable HLA-DSA (20%). We present the clinical case of a hypersensitized and retransplanted patient with early AMR manifested as severe thrombotic microangiopathy (TMA) due to non-HLA antibodies (non-HLA Ab)
Pefaur et al. (Mon,) studied this question.
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