Antibody Mediated Rejection Epidemiology Forecast

DelveInsight’s ‘Antibody-mediated Rejection (AMR) – Epidemiology Forecast—2030’ report delivers an in-depth understanding of the AMR, historical and forecasted epidemiology in the United States, EU5 (Germany, Spain, Italy, France, and the United Kingdom), and Japan.

Geographies Covered

  • The United States
  • EU5 (Germany, France, Italy, Spain, and the United Kingdom)
  • Japan

Study Period: 2017–2030

AMR Disease Understanding

Antibody-mediated rejection (AMR) is a major cause of late kidney transplant failure. Antibody-mediated rejection (AMR), also known as B-cell-mediated or humoral rejection, is a significant complication after kidney transplantation that carries a poor prognosis. However, fewer than 10% of kidney transplant patients experience AMR, as many as 30% of these patients experience graft loss as a consequence. Although antibodies mediate AMR against an allograft and results in histologic changes in allograft vasculature that differ from cellular rejection, it has not been recognized as a separate disease process until recently. With an improved understanding of the importance of the development of antibodies against allografts as well as complement activation, significant advances have occurred in the treatment of AMR.


Many unmet needs are associated with this disorder; there is no approved standard of care; subtype distinctions are not clearly defined, and increased therapy toxicity. Therefore, it becomes imperative that such needs are fulfilled to have an efficient and reliable method to treat this disease.

AMR Epidemiology

The epidemiology sections of the report are divided into the transplant incidence, AMR cases by each tumor type to have a comprehensive understanding of the disease burden. For these, nationwide studies conducted in the 7MM region along with expert estimations were used. This report concentrates on 5 major organ transplantation where Antibody-mediated rejection has been defined, i.e., Kidney, Lung, Liver, Heart, and Pancreas. For the total number of transplantation and growth rates WHO global data “Global Observatory on Donation and Transplantation” was used. For Antibody-mediated rejection rate within each organ transplantation defined by the latest available definition, various published literature was referred.


Maryvonne Hourmant did a study to evaluate the frequency and clinical implications of the development of donor-specific and non-donor-specific HLA antibodies after kidney transplantation. A total of 1229 recipients of a kidney graft, transplanted between 1972 and 2002, who had over a 5-year period a prospective annual screening for HLA antibodies with a combination of ELISA, complement-dependent cytotoxicity, and flow cytometry tests were investigated; in 543 of them, the screening was complete from transplantation to the fifth year post grafting. Correlations were established between the presence and the specificity of the antibodies and clinical parameters. A total of 5.5% of the patients had DS, 11.3% had NDS, and 83% had no HLA antibodies after transplantation. NDS antibodies appeared earlier (1 to 5 years post-transplantation) than DS antibodies (5–10 years). 


The AMR epidemiology division provides insights about the historical and current patient pool, along with the forecasted trend for every seven major countries. It helps recognize the causes of current and forecasted trends by exploring numerous studies and views of key opinion leaders. This part of our report also provides the diagnosed patient pool and their trends along with assumptions undertaken.


Key Findings

The total incident cases of AMR patients are increasing in 7MM during the study period, i.e., 2017–2030.


The disease epidemiology covered in the report provides historical as well as forecasted AMR symptoms epidemiology segmented as the Transplant incidence of AMR, and Antibody-mediated Rejection cases. The report includes the incident scenario of AMR symptoms in 7MM covering the United States, EU5 countries (Germany, France, Italy, Spain, and the United Kingdom), and Japan from 2017 to 2030.

Country-wise - AMR Epidemiology

The epidemiology segment also provides the AMR epidemiology data and findings across the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), and Japan.


The total incident cases of AMR associated in 7MM countries were 5,283 in 2020.

  • As per the estimates, the United States has the largest incident population of AMR.
  • Among the EU5 countries, France had the highest incident cases of AMR, followed by Spain. On the other hand, Germany had the lowest incident cases, with 260 cases in 2020 in EU5.

Scope of the Report

  • The AMR report covers a detailed overview explaining its causes, symptoms, and classification, pathophysiology, diagnosis, and treatment patterns.
  • The AMR Epidemiology Report and Model provide an overview of the risk factors and global trends of AMR in the seven major markets (7MM: US, France, Germany, Italy, Spain, UK, and Japan).
  • The report provides insight into the historical and forecasted patient pool of AMR in seven major markets covering the United States, EU5 (Germany, Spain, France, Italy, UK), and Japan.
  • The report helps to recognize the growth opportunities in the 7MM concerning the patient population.
  • The report assesses the disease risk and burden and highlights the unmet needs of AMR.
  • The report provides the segmentation of the AMR epidemiology by transplant incidence of AMR in 7MM.
  • The report provides the segmentation of the AMR epidemiology by antibody-mediated rejection cases in 7MM.

Report Highlights

  • 11-year Forecast of AMR epidemiology
  • 7MM Coverage
  • Incident Cases according to segmentation: Transplant incidence cases of AMR
  • Incident Cases according to segmentation: Antibody-mediated rejection cases

KOL Views

We interview KOLs, and SME's opinion through primary research to fill the data gaps and validate our secondary research. The opinion helps understand the total patient population and current treatment pattern. This will support the clients in potential upcoming novel treatment by identifying the overall scenario of the indications.

Key Questions Answered

  • What will be the growth opportunities in the 7MM for the patient population of AMR?
  • What are the key findings of the AMR epidemiology across 7MM and which country will have the highest number of patients during the forecast period (2017–2030)?
  • What would be the total number of patients of AMR across the 7MM during the forecast period (2017–2030)?
  • Among the EU5 countries, which country will have the highest number of patients during the forecast period (2017–2030)?
  • At what CAGR the patient population is expected to grow in 7MM during the forecast period (2017–2030)?
  • What are the disease risk, burdens, and unmet needs of the AMR?
  • What are the currently available treatments of AMR?

Reasons to buy

The AMR epidemiology report will allow the user to -

  • Develop business strategies by understanding the trends shaping and driving the global AMR market
  • Quantify patient populations in the global AMR market to improve product design, pricing, and launch plans
  • Organize sales and marketing efforts by identifying the age groups and sex that present the best opportunities for AMR therapeutics in each of the markets covered
  • Understand the magnitude of Transplant Incidence.
  • Understand the magnitude of AMR Incidence.
  • The AMR epidemiology report and model were written and developed by Masters and Ph D level epidemiologists
  • The AMR Epidemiology Model developed by DelveInsight is easy to navigate, interactive with dashboards, and epidemiology based on transparent and consistent methodologies. Moreover, the model supports data presented in the report and showcases disease trends over an 11-year forecast period using reputable sources

Key Assessments

  • Patient Segmentation
  • Disease Risk and Burden
  • Risk of disease by the segmentation
  • Factors driving growth in a specific patient population

1. Key Insights

2. Executive summary

3. Organizations

4. Epidemiology and Market Methodology

5. Antibody-mediated Rejection (AMR): Market Overview at a Glance

5.1. Total Market Share (%) Distribution of Antibody-mediated Rejection (AMR) in 2017

5.2. Total Market Share (%) Distribution of Antibody-mediated Rejection (AMR) in 2030

6. Antibody-mediated Rejection (AMR): Market Overview at a Glance

6.1. Introduction

6.2. Pathogenesis

6.3. Types of ABR

6.4. Risk Factors

6.5. Clinical features

6.6. Diagnosis

7. Epidemiology and Patient Population

7.1. Key Findings

7.2. Assumptions and Rationale

7.3. Total cases of Antibody-mediated Rejection (AMR) in 7MM

7.4. United States

7.4.1. Transplant Incidence cases in the United States

7.4.2. Antibody-mediated Rejection Cases in the United States

7.5. EU5 Countries

7.5.1. Germany

7.5.1.1. Transplant Incidence cases in Germany

7.5.1.2. Antibody-mediated Rejection Cases in Germany

7.5.2. France

7.5.2.1. Transplant Incidence cases in France

7.5.2.2. Antibody-mediated Rejection Cases in France

7.5.3. Italy

7.5.3.1. Transplant Incidence cases in Italy

7.5.3.2. Antibody-mediated Rejection Cases in Italy

7.5.4. Spain

7.5.4.1. Transplant Incidence cases in Spain

7.5.4.2. Antibody-mediated Rejection Cases in Spain

7.5.5. UK

7.5.5.1. Transplant Incidence cases in the United Kingdom

7.5.5.2. Antibody-mediated Rejection Cases in the United Kingdom

7.6. Japan

7.6.1. Transplant Incidence cases in Japan

7.6.2. Antibody-mediated Rejection Cases in Japan

8. KOL Views

9. Bibliography

10. Appendix

10.1. Report Methodology

11. DelveInsight Capabilities

12. Disclaimer

13. About DelveInsight

List of Table

Table 1: Banff diagnostic categories

Table 2: Antibody-mediated rejection criteria

Table 3: Total cases of Antibody-mediated Rejection (AMR) in 7MM (2017–2030)

Table 4: Transplant Incidence cases in the United States (2017–2030)

Table 5: Antibody-mediated Rejection Cases in the US (2017–2030)

Table 6: Transplant Incidence cases in Germany (2017–2030)

Table 7: Antibody-mediated Rejection Cases in Germany (2017–2030)

Table 8: Transplant Incidence cases in France (2017–2030)

Table 9: Antibody-mediated Rejection Cases in France (2017–2030)

Table 10: Transplant Incidence cases in Italy (2017–2030)

Table 11: Antibody-mediated Rejection Cases in Italy (2017–2030)

Table 12: Transplant Incidence cases in Spain (2017–2030)

Table 13: Antibody-mediated Rejection Cases in Spain (2017–2030)

Table 14: Transplant Incidence cases in the United Kingdom (2017–2030)

Table 15: Antibody-mediated Rejection Cases in the UK (2017–2030)

Table 16: Transplant Incidence cases in Japan (2017–2030)

Table 17: Antibody-mediated Rejection Cases in Japan (2017–2030)

List of Figures

Figure 1: Epidemiology and Market Methodology

Figure 2: Activation of the Classical Complement Pathway in AMR in Renal Transplant Recipients

Figure 3: Complement Activation Pathway

Figure 4: Total Cases of Antibody-mediated Rejection (AMR) in 7MM (2017–2030)

Figure 5: Transplant incidence Cases in the United States (2017–2030)

Figure 6: Antibody-mediated Rejection Cases in the US (2017–2030)

Figure 7: Transplant incidence Cases in Germany (2017–2030)

Figure 8: Antibody-mediated Rejection Cases in Germany (2017–2030)

Figure 9: Transplant incidence Cases in France (2017–2030)

Figure 10: Antibody-mediated Rejection Cases in France (2017–2030)

Figure 11: Transplant incidence Cases in Italy (2017–2030)

Figure 12: Antibody-mediated Rejection Cases in Italy (2017–2030)

Figure 13: Transplant incidence Cases in Spain (2017–2030)

Figure 14: Antibody-mediated Rejection Cases in Spain (2017–2030)

Figure 15: Transplant incidence Cases in the United Kingdom (2017–2030)

Figure 16: Antibody-mediated Rejection Cases in the UK (2017–2030)

Figure 17: Transplant incidence Cases in Japan (2017–2030)

Figure 18: Antibody-mediated Rejection Cases in Japan (2017–2030)

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