Antibody-Mediated Rejection After Liver Transplant

Gastroenterol Clin North Am. 2017 Jun;46(2):297-309. doi: 10.1016/j.gtc.2017.01.005.


Antibody-mediated rejection (AMR) in liver transplants is a field in its infancy compared with its allograft cohorts of the kidney and lung. Acute AMR is diagnosed based on specific clinical and histopathologic criteria: serum donor specific antibodies, C4d staining, histopathologic findings on liver biopsy, and exclusion of other entities. In contrast, the histologic features of chronic AMR are not as specific and it is a more challenging diagnosis to make. Treatments of acute and chronic AMR include some combination of steroids, immune-modulating agents, intravenous immunoglobulin, plasmapheresis, and proteasome inhibitors.

Keywords: Antibody-mediated rejection; Liver; Transplant.

Publication types

  • Review

MeSH terms

  • Allografts / immunology
  • Antibodies / blood*
  • Complement C4b / analysis
  • Graft Rejection / drug therapy
  • Graft Rejection / immunology*
  • Graft Rejection / pathology*
  • HLA Antigens / immunology
  • Humans
  • Liver Transplantation*
  • Liver*
  • Peptide Fragments / analysis


  • Antibodies
  • HLA Antigens
  • Peptide Fragments
  • Complement C4b
  • complement C4d