Chronic Antibody Mediated Rejection, a Continuous and Complex Lesion

Introduction: With the advent of more potent immunosuppression, early outcomes after kidney transplantation have been excellent. However, the long-term survival of renal allograft remains a difficult and unanswered question as most of the renal transplants undergo failure within a decade. Case Report: A 43-year-old male with end-stage renal disease of undetermined aetiology was submitted to kidney transplantation from an ABO incompatible donor. During the first 12 months of follow-up, this patient was submitted to 6 biopsies in the context of worsening renal function. The first biopsy was Conclusion:The presence of pathogenic antibodies against non-HLA molecules should always be considered, particularly in the absence of detectable DSA with histological evidence of humoral response.