How do you approach the management of a kidney transplant recipient who develops de novo donor-specific antibodies but shows no clinical signs of rejection or graft dysfunction?  

Context is important. Was this part of a surveillance protocol for a high risk patient to monitor for DSA early post transplant? Or checked prior to making changes to immunosuppression eg Belatacept conversion?  Creatinine and proteinuria are late signs of graft damage. So even if neither is p...