Intragraft donor-specific antibodies reflect histologic heterogeneity in kidney allografts with concurrent serum DSA
By
Hyunjae Lee
Eun Youn Roh
Tae-Shin Kim
Yu Jung Choi
Inseong Oh
Hajeong Lee
Sang Il Min
Chang Wook Jeong
Hee Gyung Kang
Jongwon Ha
Kyung Chul Moon
Eun Young Song
June 23, 2026
Clinical Scorecard: Intragraft Donor-Specific Antibodies Correlate with Histological Variability in Kidney Allografts Accompanied by Serum DSA
At a Glance
Category Detail
Condition Kidney Transplantation Key Mechanisms Intragraft donor-specific antibodies (gDSA) and circulating donor-specific antibodies (sDSA) impact antibody-mediated rejection (ABMR). Target Population Kidney transplant recipients with concurrent weak to moderate serum DSA. Care Setting Clinical transplantation and histopathology.
Key Highlights
gDSA positivity varies significantly across histologic diagnoses. Highest gDSA positivity observed in C4d-only lesions and active ABMR. gDSA may provide additional context for histologic variability in kidney transplants. Guideline-Based Recommendations
Diagnosis
Utilize the Banff 2022 classification framework for histologic evaluation. Management
Monitor for the presence of gDSA in conjunction with sDSA in kidney transplant recipients. Monitoring & Follow-up
Assess gDSA levels in biopsy eluates to evaluate immunologic responses. Risks
Recipients with sDSA are at increased risk for ABMR and graft failure. Patient & Prescribing Data
Patients with kidney transplants and concurrent weak to moderate sDSA.
Management strategies include high-resolution HLA typing and monitoring for DSA formation.
Clinical Best Practices
Conduct regular biopsies to assess for rejection in patients with sDSA. Implement sensitive assays for DSA detection to guide treatment. Related Resources & Content
