Antibody Mediated Rejection

Many people who are on the wait list for a kidney transplant have harmful antibodies, called donor specific antibodies (DSA), which will attack foreign tissue such as the transplanted organ. These people are considered to be"sensitized". Prior to receiving a kidney, these patients undergo desensitization treatments to remove these harmful antibodies. Levels of DSA are measured after desensitization, but the cells that produce the DSA, donor specific B cells (DSB), have not generally been measured. Additionally, if a person experiences chronic rejection due to antibodies they are also desensitized, but only the DSA are measured. This study will measure the DSA and, using new techniques, the DSB in two study groups: those who are receiving an organ and those experiencing chronic antibody mediated rejection after receiving an organ. The hypothesis is people with higher levels of DSB after desensitization are more likely to develop antibody mediated rejection.