Management of Cellular and Humoral Rejection: Prevention, Diagnosis, and Treatment

  • Erika D. LeaseEmail author
  • Ganesh Raghu


Acute cellular and antibody-mediated (humoral) rejections are two forms of acute rejection seen following lung transplantation. The management of acute cellular and antibody-mediated rejection is complex and may be individualized based on the unique situation of each patient. The prevention of acute cellular rejection starts with induction immunosuppression and frequent clinical monitoring as well as through the management of potential risk factors such as gastroesophageal reflux disease and various infections. Antibody-mediated rejection is less understood and requires further study. The mainstay of treatment for acute cellular rejection as well as antibody-mediated rejection is through the augmentation of immunosuppression through a variety of medical strategies. The management of acute cellular rejection and antibody-mediated rejection is important due to the associations with the development of chronic lung allograft dysfunction, the primary cause of mortality following lung transplantation. With optimal management and further study, the goal is for improved survival and quality of life for all lung transplant recipients.


Lung transplant Acute cellular rejection Antibody-mediated rejection Prevention Treatment 



Acute cellular rejection


Antibody-mediated rejection


Antithymocyte globulin


Bronchoalveolar lavage


Bronchiolitis obliterans syndrome


Complement-dependent cytotoxicity


Chronic lung allograft dysfunction




Calculated panel reactive antibody


Donor-specific antibody


Enzyme-linked immunosorbent assay


Forced expiratory volume in 1 second


Forced vital capacity


Gastroesophageal reflux disease


Human leukocyte antigen


High-resolution computed tomography


International Society for Heart and Lung Transplantation


Intravenous immunoglobulin


Mean fluorescent intensity




Panel reactive antibody


Transbronchial biopsy


United network of sharing


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Copyright information

© The Author(s) 2018

Authors and Affiliations

  1. 1.Division of Pulmonary, Critical Care, and Sleep MedicineUniversity of WashingtonSeattleUSA
  2. 2.Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine University of WashingtonSeattleUSA
  3. 3.Center for Interstitial Lung Disease, ILD, Sarcoid and Pulmonary Fibrosis Program, University of Washington MedicineSeattleUSA
  4. 4.Scleroderma Clinic, University of Washington MedicineSeattleUSA

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