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The detrimental effects of preformed and de novo development of donor specific anti HLA antibodies in solid organ transplantation have been extensively reviewed and are found to be of prime importance leading to graft rejection.The potential role of non-HLA antibodies in allograft rejection, particularly those directed against endothelial cells is beginning to be realized.Of these, MICA (Major Histocompatibility Complex class Ⅰ chain related molecule A) antibodies are the most notable and notorious one because of their potential in promoting hyper acute rejection and/or acute AMR (antibody mediated rejection) as well as chronic AMR.