Non-HLA antibody responses following solid organ transplantation have become increasingly emphasised, with several large clinical series suggesting that such responses contribute to late graft failure. Many of the responses described recognise both recipient and donor moieties of the target antigen and thus represent auto-, rather than allo-immunity. Within this rapidly evolving field, many questions remain unanswered: what triggers the response; how innate and adaptive humoral autoimmunity integrate; and most pressingly, how autoimmunity contributes to graft damage and its relationship to other effector mechanisms of graft rejection. This review summarises recent clinical and experimental studies of humoral autoimmunity in transplant rejection, and considers some of the answers to these questions.

实体器官移植后的非HLA抗体应答已日益受到重视，一些大型临床研究表明此类应答可导致晚期移植失败。所描述的许多反应均识别靶抗原的受体和供体部分，因此代表自身免疫而非同种免疫。在这个快速发展的领域中，许多问题仍未得到解答：是什么触发了响应；先天性和适应性体液自身免疫如何整合；最紧迫的是，自身免疫如何导致移植物损伤及其与其他排斥反应效应器机制的关系。这篇综述总结了移植排斥反应中体液自身免疫的最新临床和实验研究，并考虑了这些问题的一些答案。