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Angiotensin Type 1 Receptor Antibody-Mediated Rejection in a Kidney Transplant Recipient

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Abstract

Antibody-mediated rejection of a kidney allograft can be caused by non-human leukocyte antigen (HLA) antibodies such as Angiotensin Type 1 Receptor (AT1R) antibodies. AT1R antibodies are associated with an increased risk of early rejection and reduced long-term allograft survival. Although infrequent, a high index of suspicion for AT1R antibody-mediated rejection is warranted when there is histologic evidence of antibody-mediated injury in the allograft but no identified donor-specific HLA antibody. Treatment options for AT1R antibody-mediated rejection include the use of angiotensin receptor blockade in addition to other antibody-directed therapies.

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References

  1. Philogene M, Johnson T, Vaught A, et al. Antibodies against angiotensin II type 1 and endothelin a receptors: relevance and pathogenicity. Hum Immunol. 2019;80:561–7. https://doi.org/10.1016/j.humimm.2019.04.012.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Dragun D, Muller D, Brasen J, et al. Angiotensin II type 1-receptor activating antibodies in renal allograft rejection. N Engl J Med. 2005;352:558–69.

    Article  PubMed  Google Scholar 

  3. Giral M, Foucher Y, Dufay A, et al. Pretransplant sensitization against angiotensin II type 1 receptor is a risk factor for acute rejection and graft loss. Am J Transplant. 2013;13:2567–76. https://doi.org/10.1111/ajt.12397.

    Article  PubMed  Google Scholar 

  4. Lefaucher C, Viglietti D, Bouatou Y, et al. Non-HLA agonistic anti-angiotensin II type 1 receptor antibodies induce a distinctive phenotype of antibody-mediated rejection in kidney transplant recipients. Kidney Int. 2019;96:189–201. https://doi.org/10.1016/j.kint.2019.01.030.

    Article  Google Scholar 

  5. Carrol R, Riceman M, Hope C, et al. Angiotensin II type-1 receptor antibody (AT1Rab) associated with humoral rejection and the effect of peri operative plasma exchange and candesartan. Hum Immunol. 2016;77:1154–8. https://doi.org/10.1016/j.humimm.2016.08.009.

    Article  Google Scholar 

  6. Karpel H, Ali N, Lawson N, et al. Successful A2 to B deceased donor kidney transplant after desensitization for high-strength non-HLA antibody made possible by utilizing a hepatitis C positive donor. Case Reports in Transplantation. 2020; https://doi.org/10.1155/2020/3591274.

  7. Philogene M, Zhou S, Lonze B, et al. Pre-transplant screening for non-HLA antibodies: who should be tested? Hum Immunol. 2018;79:195–202. https://doi.org/10.1016/j.humimm.2018.02.001.

    Article  PubMed  Google Scholar 

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Correspondence to Beatrice P. Concepcion .

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Sarrell, B.A., Concepcion, B.P. (2022). Angiotensin Type 1 Receptor Antibody-Mediated Rejection in a Kidney Transplant Recipient. In: Aziz, F., Parajuli, S. (eds) Complications in Kidney Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-031-13569-9_37

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  • DOI: https://doi.org/10.1007/978-3-031-13569-9_37

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-13568-2

  • Online ISBN: 978-3-031-13569-9

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