Dr Zeevi discusses new diagnostic tools, including the C1q-DSA assay, which detects antibodies that are capable of binding and fixing the first complement protein, C1q [1-3], and can therefore aid in risk stratification BGB324 in vivo of transplant recipients who exhibit DSA. Early detection of DSA and intervention strategies may impact long-term allograft survival. Dr Lefaucheur presents the results of a population-based study of kidney-transplant recipients who were screened for the presence of circulating DSA at the time of transplantation

and at 1 year after transplantation. A risk prediction model that incorporates the ability of DSA to bind complement demonstrates an improved risk stratification process which aids identification of patients at high risk of graft loss, leading potentially to specific and personalized treatment options. The deleterious effects of antibodies to HLA antigens are well known and prohibitive to transplantation. For example, patients with elevated anti-HLA antibodies often wait for extended periods for a compatible organ [4]. Desensitization protocols using IVIg in combination with plasma exchange and/or rituximab have been developed to optimize the availability of compatible donors [5, 6]. Dr Vo discusses data regarding the safety, efficacy

and economic aspects of the current desensitization protocols. Professor Legendre discusses AMR in more detail, and highlights that various phenotypes of acute AMR exist, including subclinical AMR [7], C4d-negative AMR [8], AMR with vascular lesions [9] and AMR without anti-HLA antibodies but with DSA of Selleck Luminespib other origin [10, 11]. These phenotypes vary in severity and potentially

require different treatments, highlighting that accurate diagnosis is essential for effective treatment strategies. In contrast to the role of DSAs and AMR in DOCK10 allograft survival, Dr Clatworthy discusses the various effects of B cells. There is an appreciation that B cells may play a function in acute cellular rejection and are probably important in rebound AMR after incompatible kidney transplantation. However, aside from the negative effects of B cells and antibody on the allograft, evidence suggests that B cells may have a favourable effect on long-term graft survival, due possibly to the effect of ‘regulatory’ B cells [12-14]. Possible strategies to target B cells are presented. Hypogammaglobulinaemia (HGG) is a known complication of solid organ transplantation and is associated with an increased risk of infection. Monitoring serum immunoglobulin G (IgG) levels before and after transplantation has been proposed as a tool to predict clinical outcomes. Dr Florescu presents the results of a meta-analysis that was performed to evaluate the risk of HGG and its impact on the rate of opportunistic infections during the first year post-transplantation [15].