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. Author manuscript; available in PMC: 2020 Mar 1.
Published in final edited form as: Clin Lab Med. 2018 Dec 20;39(1):31–43. doi: 10.1016/j.cll.2018.10.004

Figure 4. Mechanisms through which complement modulates antibody-mediated rejection.

Figure 4.

Donor specific antibodies (DSA) bind to donor human leukocyte antigen (HLA) on endothelial cells and initiate complement activation via the classical pathway, leading to complement deposition, local C3a/C5a production, and MAC formation. The latter causes non-canonical NF-κB signaling that initiates a pro-inflammatory gene program, enhancing recruitment of alloreactive T cells and development of vascular injury.