Angiotensin II Type 1 Receptor Antibody-Mediated Kidney Rejection Unresponsive to Treatment

Allograft rejection is a significant cause of renal transplant failure which needs prompt diagnosis and treatment for graft salvage. Angiotensin II type 1 receptor antibody-mediated (AT1R-AMR) increasingly being identified as the etiology in kidney recipients with allograft but without detectable human leukocyte antigen (HLA) antibodies. While some reports have suggested that AT1R-AMR may be refractory to standard therapy, others reported improvement or stabilization function. We present two patients anti-rejection therapy including therapeutic plasma exchange was unable salvage allograft.