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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Mar 18, 2026; 16(1): 111524
Published online Mar 18, 2026. doi: 10.5500/wjt.v16.i1.111524
Published online Mar 18, 2026. doi: 10.5500/wjt.v16.i1.111524
Update on diagnostic and therapeutic strategies for antibody-mediated rejection in kidney transplantation
Tabassum Elahi, Saima Ahmed, Department of Nephrology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
Muhammed Mubarak, Department of Histopathology, Sindh Institute of Urology and Trans
Author contributions: Elahi T and Ahmed S performed the literature search and prepared the initial draft of the manuscript; Mubarak M meticulously revised and refined the manuscript; Elahi T, Ahmed S, and Mubarak M actively participated in the conceptualization and planning of the study; and all authors reviewed and approved the final version.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Muhammed Mubarak, Department of Histopathology, Sindh Institute of Urology and Transplantation, Chand Bibi Road, Karachi 74200, Sindh, Pakistan.
Received: July 2, 2025
Revised: August 23, 2025
Accepted: December 1, 2025
Published online: March 18, 2026
Processing time: 196 Days and 22.5 Hours
Revised: August 23, 2025
Accepted: December 1, 2025
Published online: March 18, 2026
Processing time: 196 Days and 22.5 Hours
Core Tip
Core Tip: Antibody-mediated rejection remains a leading cause of kidney graft dysfunction and failure. While donor-specific antibodies are a key risk factor, not all are pathogenic. Current diagnostic markers lack sensitivity and often miss subclinical changes, with definitive diagnosis still relying on invasive biopsy. The clinical adoption of noninvasive biomarkers continues to face significant hurdles. Despite advances in understanding antibody-mediated rejection biology, no standar