Background Antibody-mediated rejection (AMR) was described in kidney transplant patients after viral infections, such as the cytomegalovirus. Very few cases were recently reported after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, probably in the context of lowering of immunosuppressive therapy. To date, no direct immunological link was proved to explain a connection between the coronavirus disease 19 (COVID-19) infection and antibody-mediated rejection (AMR) if it exists. Case presentation Here we try to find this association by presenting the case of a low immunological risk patient who presented, six years post-transplant, with c4d negative antibody mediated rejection due to an anti-HLA-C17 de novo donor specific antibody (DSA) after contracting the coronavirus disease 19. The HLA-Cw17 activated the antibody-dependent cell-mediated cytotoxicity via the KIR2DS1 positive NK cells. Discussion and conclusions This case report may prove a direct role for COVID-19 infection in AMRs in the kidney transplant recipients, leading us to closely monitor kidney transplant recipients, especially if they have “at-risk” donor antigens.
【저자키워드】 Case report, COVID 19, Antibody mediated rejection, Natural killers, 【초록키워드】 COVID-19, coronavirus disease, coronavirus, therapy, antibody, Infection, NK cells, risk, cytotoxicity, severe acute respiratory syndrome Coronavirus, viral infections, Viral, COVID-19 infection, Transplant, Patient, antigens, cytomegalovirus, respiratory, kidney transplant, immunosuppressive therapy, Donor, association, kidney transplant recipients, immunosuppressive, antibody-dependent cell-mediated cytotoxicity, connection, acute respiratory syndrome, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, lowering, positive, Cell-mediated cytotoxicity, KIR2DS1, rejection, de novo, MONITOR, immunological, described, reported, activated, presenting, explain, 【제목키워드】 kidney transplant, rejection,