Based upon the underlying mechanism and pathological evidence of tissue injury of antibody-mediated rejection(AMR),four etiological and symptomatic therapies were proposed for managing AMR,including etiological treatment of AMR including antibody-targeting,B cell or plasma cell-targeting therapies;strategies for preventing antibody-mediated endothelial damage:an inhibition of complement/antibody dependent cell-mediated pathways;anticoagulant &thrombolytic therapies for thrombotic microangiopathy secondary to endothelial damage;anti-inflammatory therapies for acute/chronic vascular inflammation secondary to endothelial damage.Etiological treatment is essential for preventing and treating AMR while symptomatic measures,such as anticoagulant,thrombolytic and anti-inflammatory therapies,are stressed.Finally the authors devised therapeutic strategies for AMR in 4 different patient groups of non-sensitized allograft recipients,sensitized allograft recipients,individuals with active AMR and those with chronic active AMR.
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