A growing body of evidence shows that donor-specific antibodies (DSA) are associated with rejection and allograft failure following both liver and intestinal transplantation. However, data have clearly shown that not all DSA are injurious. The reasons for this remain unclear but appear to be multifactorial, impacted by clinical factors such as immunosuppression and infection as well as immunologic factors such as HLA expression and donor-specific antibodies affinity. Establishing a diagnosis of antibody-mediated rejection (AMR) remains clinically challenging, especially given that AMR can present as either acute or chronic graft dysfunction. These observations highlight the need for a better understanding of the immune mechanisms by which DSA and AMR contribute to rejection and allograft failure. This review focuses on current knowledge of DSA and AMR in liver and intestinal transplant recipients and specifically highlights the clinical impact, prevalence, and pathogenesis.

越来越多的证据表明，肝和肠移植后，供体特异性抗体（DSA）与排斥和同种异体移植失败相关。但是，数据清楚地表明，并非所有DSA都是有害的。其原因尚不清楚，但似乎是多因素的，受临床因素如免疫抑制和感染以及免疫学因素如HLA表达和供体特异性抗体亲和力的影响。建立抗体介导的排斥反应（AMR）的诊断在临床上仍然具有挑战性，特别是考虑到AMR可以表现为急性或慢性移植物功能障碍。这些观察结果强调需要更好地了解DSA和AMR有助于排斥和同种异体移植失败的免疫机制。