*Purpose: It is important to determine the clinical significance of non-human leukocyte antigen (HLA) antibodies and their association with antibody-mediated rejection (ABMR) of kidney allografts.

*Methods: We collected post-transplant sera from 68 ABMR patients, 67 T-cell mediated rejection (TCMR) patients, and 83 control subjects without rejection, and determined the levels of 39 non-HLA antibodies. We compared the non-HLA antibody levels among the study groups. We investigated their association with the risk of death-censored graft failure in ABMR cases.

*Results: Among the antibodies evaluated, anti-collagen type I (P = 0.001) and type III (P < 0.001) antibody levels were significantly higher in ABMR cases than in TCMR cases and no-rejection controls. Both anti-collagen type I [per 1 SD, adjusted OR, 11.72 (2.73-76.30)] and type III [per 1 SD, adjusted OR, 6.22 (1.91-31.75)] antibodies were significantly associated with the presence of ABMR. Among ABMR cases, a higher level of anti-collagen type I [per 1 SD, adjusted HR), 1.82 (1.28-2.58)] or type III [adjusted HR, 1.53 (1.14-2.07)] antibody was associated with a higher risk of death-censored graft failure.

*Conclusions: Post-transplant anti-collagen I and collagen III antibodies may be novel non-HLA antibodies related to ABMR of kidney allografts.

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