It has been discovered that significantly elevated levels of anti-apoptotic cell IgG is an important contributor to and predictor of late graft rejection. Kaplan-Meier survival analysis revealed that patients with high pre-transplant IgG and post-transplant reactivity to apoptotic cells had a significantly increased rate of late graft loss that was apparent after approximately 1 year post-transplant. This association between pre-transplant IgG reactivity to apoptotic cells and graft loss was still significant after excluding patients with high reactivity to HLA, and it was almost exclusively mediated by IgG1 and IgG3 with complement fixing and activating properties. The association between elevated levels of anti-apoptotic cell IgG antibodies and late transplant rejection forms a basis for diagnosing and treating patients at high risk of late transplant rejection.
