Clinical conundrums in pediatric kidney transplantation: What we know about the role of angiotensin II type I receptor antibodies in pediatric kidney transplantation and the path forward

Abstract

AbstractAntibodies to angiotensin II type 1 receptor (AT1R‐Abs) are among the most well‐studied non‐HLA antibodies in renal transplantation. These antibodies have been shown to be common in pediatric kidney transplantation and associated with antibody‐mediated rejection (AMR), vascular inflammation, development of human leukocyte donor‐specific antibodies (HLA DSA), and allograft loss. As AT1R‐Ab testing becomes more readily accessible, evidence to guide clinical practice for testing and treating AT1R‐Ab positivity in pediatric kidney transplant recipients remains limited. This review discusses the clinical complexities of evaluating AT1R‐Abs given the current available evidence.