84,85) Within the population of ABO-compatible grafts, recipients with known, preformed lymphocytotoxic antibodies
to the donor (positive cross-matches) are at higher risk for developing ABMR,86-90 whereas cross-match-negative transplants appear to have minimal risk of isolated ABMR.
Immunoglobulin class and specificity of lymphocytotoxic antibodies
after kidney transplantation.
Several case reports have described hyperacute and acute humoral rejection in patients with preformed antibodies, most frequently immunoglobulin G (IgG) lymphocytotoxic antibodies.
Clinical and endoscopic features strongly suggesting AMR include unexplained severe ischemic injury shortly after reperfusion, mucosal persistent diffuse congestion and hemorrhage, and a strong crossmatch for T- or B-cell lymphocytotoxic antibodies.