Most common solid organ transplantation is kidney transplantation which is preferred for all end-stage renal disease (ESRD), as it offers improve quality of life and survival. If chronic kidney disease (CKD) stage 4 (GFR<30ml/min/1.73m2), transplantation should be discussed.Kidney transplant rejections are classified into T-cell mediated (acute cellular rejection) and antibody mediated rejection (AMR). 3 type of AMR; hyperacute (occurs due to DSA present in high titer within minutes. Hemorrhagic cortical necrosis, neutrophil and platelet accumulation occurs in glomeruli and peritubular capillary), acute (suddenly onset of graft dysfunction that often arise in first weeks after transplantation. It is characterized by presence of DSA, impaired urine output, C4d deposition in peritubular capillary), chronic (It is slow, progressive loss of graft function that usually develops 1 year after transplantation. Aim of treatment AMR: Antibody removal by plasmapheresis, immunoadsorbtion, intravenous immunoglobulin, splenectomy; anti-B-cell therapy by rituximab, IVIG; antiplasma cell therapy bortezomib; anti-T-cell therapy by antithymocyte globulin; terminal-complement pathway inhibitor by eculizumab.