Chiu HF, Wen MC, Wu MJ, et al. - Researchers tried to define the optimal treatment strategies for chronic active antibody-mediated rejection in renal transplant recipients. They obtained renal transplant biopsies done in the preceding 7 years with a diagnosis of chronic active antibody-mediated rejection, by using computerized records from Taichung Veterans General Hospital. Based on the treatment strategy, two groups were defined: Group 1 was managed with aggressive therapy (double filtration plasmapheresis and one of the followings: rituximab, intravenous immunoglobulin, antithymogycte globulin, bortezomib, or methylprednisolone pulse therapy), and supportive treatment was received by group 2. A worse survival was experienced by group 2, as revealed in the Kaplan-Meier analysis of death-censored graft survival. Findings revealed a better graft outcome in relation to aggressive treatment. However, the observed higher incidence of adverse events justify personalized therapy, particularly for those carrying a higher risk of infection. Patients undergoing aggressive treatment should be given appropriate prophylactic antibiotics.