Harnessing the B Cell Response in Kidney Transplantation – Current State and Future Directions
Imran J. Anwar, Isabel DeLaura, Qimeng Gao, Joseph M. Ladowski, Annette M. Jackson, Jean Kwun, Stuart J. Knechtle
Abstract
Despite dramatic improvement in kidney transplantation outcomes over the last decades due to advent of modern immunosuppressive agents, long-term outcomes remain poor. Antibody-mediated rejection (ABMR), a B cell driven process, accounts for the majority of chronic graft failures. There are currently no FDA-approved regimens for ABMR; however, several clinical trials are currently on-going. In this review, we present current mechanisms of B cell response in kidney transplantation, the clinical impact of sensitization and ABMR, the B cell response under current immunosuppressive regimens, and ongoing clinical trials for ABMR and desensitization treatment.