Current and future challenges in therapy for antibody-mediated rejection.

摘要: Antibody-mediated rejection (AMR) continues to present a challenge for the survival of cardiac allograft. AMR appears be on rise, likely secondary changing trends in clinical practice, including selection patients transplantation mechanical circulatory support and development more effective combinations immunosuppressive drugs against acute cellular rejection. Most current strategies are aimed at treating AMR, but treatment chronic is still not well defined. Clinically, can often severe than difficult treat, responding typical protocols increased immunosuppression. Complex steps involved antibody response allows several potential targets therapeutic intervention, suppression T B cells, elimination circulating antibodies, inhibition residual antibodies. Existing evidence suggests multiregimen approach best option. Sustenance accommodation induction tolerance could viewed as viable options if adequate immune surveillance achieved this setting. This review discusses challenges provides critical analysis possible future therapies.