Humoral immunity and antibody-mediated rejection in solid organ transplantation

Robert A. Montgomery, Emanuele Cozzi, Lori J. West, Daniel S. Warren

Research output: Contribution to journalReview articlepeer-review

47 Scopus citations


The humoral arm of the immune system provides robust protection against extracellular pathogens via the production of antibody molecules that neutralize or facilitate the destruction of microorganisms. However, the humoral immune system also provides a significant barrier to solid organ transplantation due to the antibody-mediated recognition of non-self proteins and carbohydrates expressed on transplanted organs. Historically, the presence of donor-specific antibodies (DSA) that recognize donor HLA molecules, incompatible ABO blood group antigens and other endothelial or xenogeneic antigens was considered a contraindication to transplantation. However, recent advances in antibody testing and immunosuppressive therapies have made it possible to cross certain antibody barriers successfully. In this article, we review our current understanding of antibody-mediated processes in solid organ transplantation and discuss the clinically available treatment options for preventing and treating antibody-mediated rejection.

Original languageEnglish (US)
Pages (from-to)224-234
Number of pages11
JournalSeminars in immunology
Issue number4
StatePublished - Aug 2011


  • ABO incompatible
  • Anti-endothelial antibody
  • Antibody mediated rejection
  • HLA antibody
  • Humoral rejection
  • Positive crossmatch

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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