One third of organ transplants are lost to transplant rejection. Although acute transplant rejection responds relatively well to steroids, chronic rejection (which is mainly mediated by antibodies) has no effective treatment. A newly discovered structure has revealed unexpected insights about the how antibodies in the recipient (alloantibodies) bind to the human leukocyte antigen (HLA) on the transplant. These insights will inform the development of novel therapies for chronic rejection.
