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Walk the Even Hospital Database by book and chapter — the raw source passages that ground Ask, DDx, and the rest.
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©2013 UpToDate ® Print Email Algorithm for the diagnosis of antibody-mediated rejection of renal allograft without renal dysfunction Algorithm proposed by the Antibody Working Group for the diagnosis of antibody-mediated rejection (AMR), if allograft dysfunction is not present. This largely represents the clinical setting in which protocol biopsies are performed in patients undergoing desensitization protocols, which is an obvious high-risk setting for AMR. Additional high risk settings include husband to wife or child to mother donor-recipient pairs, history of a sensitizing event (such as pregnancy, tranfusion, transplant), and a knowledge of HLA-specific antibody (either present or historic). This determines the predictive value of the various histologic and laboratory features, which are the major diagnostic modifiers. The presence of donor-specific antibody (DSA) is not essential for the diagnosis of AMR in these high-risk situations, if there is positive C4d staining and light microscopic features characteristic of AMR. Adapted from Montgomery, RA, et al. Transplantation 2004; 78:181.