Antibody mediated rejection. Evidence based medicine. What is the current evidence?

Antibody mediated rejection (ABMR) is a major cause of kidney graft loss. The ideal treatment remains unknown, is not standardized and there is little evidence to support the use of any specific therapy. This paper aims to reflect on the current state of this challenging diagnosis, either active or...

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Detalhes bibliográficos
Autor principal: Menezes,Maria do Mar (author)
Outros Autores: Aires,Inês (author), Nolasco,Fernando (author)
Formato: article
Idioma:eng
Publicado em: 2020
Assuntos:
Texto completo:http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692020000300004
País:Portugal
Oai:oai:scielo:S0872-01692020000300004
Descrição
Resumo:Antibody mediated rejection (ABMR) is a major cause of kidney graft loss. The ideal treatment remains unknown, is not standardized and there is little evidence to support the use of any specific therapy. This paper aims to reflect on the current state of this challenging diagnosis, either active or chronic active ABMR, and its treatment options. The current treatments encompass plasma exchange, steroids, intravenous immunoglobulin, rituximab, bortezomib, eculizumab, C1 inhibitors, IL 6 inhibitors and IgG-degrading enzyme of Streptococcus pyogenes among others. We will try to analyze the main studies that sustain or reject the current and future use of these techniques and drugs.