Transcriptional changes in kidney allografts with histology of antibody-mediated rejection

Circulating anti-HLA donor-specific antibodies (HLA-DSA) are often absent in serum of kidney allograft recipients with biopsies demonstrating histology of antibody-mediated rejection (ABMRh). In this multicenter study, we aimed to elucidate whether the transcriptional profile of biopsies with HLA-DSA negative ABMRh can indicate an undetected humoral etiology, or whether HLA-DSA negative ABMRh should be considered as a distinct histomolecular entity. We performed microarray analysis of 224 kidney allograft biopsies, collected from unique recipients in 4 European centers. The transcriptional profile of biopsies without ABMRh (n=168), DSA negative ABMRh (n=26) and DSA positive ABMRh (n=30) was compared.