TABLE 2.

Association between changes in DSA and graft outcome in kidney transplantation RCTs. No studies show that interventions that affect DSA predict long-term graft outcomes (55, 61–63).

Study	Setting and intervention	Effect on DSA	Effect on graft outcome
Bray et al., 2018 (55)	Belatacept vs. cyclosporine in the BENEFIT and BENEFIT-EXT studies	Significantly lower risk of dnDSA development and lower MFI of these DSA	Significantly better overall graft failure but equal death-censored graft failure and AMR risk
Moreso et al., 2018 (61)	IVIG + rituximab for chronic AMR	No change in immunodominant DSA-MFI between baseline and 1 year	No change in renal function assessed by eGFR (underpowered study)
Eskandary et al., 2018 (62)	Bortezomib vs. placebo for treatment of late AMR	No change in DSA-MFI	No change in renal function assessed by eGFR or graft failure
Sautenet et al., 2016 (63)	Rituximab vs. placebo for AMR	Significantly decreased DSA-MFI	No effect of the intervention on graft function or graft survival (underpowered study)

AMR, antibody-mediated rejection; dn, de novo; DSA, donor-specific antibodies; eGFR, estimated glomerular filtration rate; IVIG, intravenous immunoglobulin; MFI, mean fluorescence intensity; RCT, randomized controlled trial.