Non-HLA Antibodies and the Risk of Antibody-mediated Rejection without Donor-specific Anti-HLA Antibodies After Lung Transplantation.

Background: Antibody-mediated rejection (ABMR) has become one of the leading causes of chronic lung graft dysfunction. However, in lung transplantation, this entity is sometimes difficult and controversial to diagnose. It is mainly caused by the appearance of donor-specific anti-human leukocyte antigen (HLA) antibodies (DSA), although there are situations with C4d deposits in biopsy in the absence of circulating DSA.