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Mechanisms and Role of HLA and non-HLA Alloantibodies

Transplantation Research Center, Brigham and Women’s Hospital, Boston, Massachusetts

Address correspondence to: Dr. Kathryn J. Tinckam, Brigham and Women’s Hospital, Tissue Typing Lab, PBB 161, 75 Francis Street, Boston, MA 02115. Phone: 617-732-8562; Fax: 617-264-5104; E-mail: ktinckam{at}rics.bwh.harvard.edu

The role of alloantibodies against HLA and non-HLA targets is becoming increasingly recognized as critical in the pathogenesis of acute and chronic renal allograft outcomes. This review discusses the antigenic targets, the mechanisms of T and B cell activation that result in the production of antibody, the complement cascade, methods of antibody detection, and the evidence that alloantibody-mediated mechanisms are active in acute and chronic rejection.