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Introduction Humoral alloimmunity mediated by donor-specific Human leukocyte antigen (HLA) antibodies (DSAs) is the principal cause of acute and chronic antibody mediated rejection (ABMR) leading to kidney graft damage and having a major impact on graft survival ( Despite a clear association of DSAs with ABMR and poor long term graft outcome, recipients of renal transplants from HLA-identical siblings have been reported to develop accelerated ABMR ( In addition to cell surface antigens, non-HLA antibodies may recognize cryptic antigens that become exposed after tissue damage prompted by ischemia-reperfusion, alloimmunity, and/or chronic inflammation

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We intend to update the proposed CMI values in the FY 2024 final rule to reflect the updated FY 2022 MedPAR file, which will contain data from additional bills received through March 2023

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