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Antibody mediated rejection（ AMR） in transplant recipients may cause graft dysfunction and decreased graft survival1. Most of these patients have donor specific antibodies（ DSA）， C4d staining in peritubular capillaries and histological evidence of acute rejection on renal biopsy2. Current treatment options for AMR include plasma exchange（ PP）， intravenous immunoglobulin（ IVIG） and anti-CD 20 therapy3. Patients with severe forms of AMR usually do not respond to these treatments.