If TCMR is a result of a recipient T - cell mediated immune response targeting the donor allograft resulting in allograft injury of various severity with 20 - 40% after liver transplantation then antibody mediated rejection (AMR) is very rare complication of liver transplantation with a reported frequency of 0,3 - 2%, but can have very serious consequences such as early graft los or cirrhosis. Identifying and treatment AMR remain difficult due to the complexity of immunological and pathology diagnosis, lack of guidelines and long term monitoring. Treatment AMR after liver transplantation is often based on the experience of other centers and the kidney transplant team, including corticoid, plasma exchange, high dose of IVIG , may be combined with rituximab. In this case, we reported a case mixed transplant rejection between TCMR and AMR after liver transplant in a patient with biliary atresia - end stage liver disease with evidence of liver biosy and elevated anti HLA antiobodies (HLA PRA class I and II)
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