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Kidney allograft rejection is driven by a spectrum of immune mechanisms in which host T-cells, donor-specific antibodies and innate effectors collectively injure the graft. Acute T-cell-mediated rejection manifests histologically with interstitial mononuclear infiltrates, tubulitis, and intimal arteritis, whereas antibody-mediated rejection is characterized by microvascular inflammation, peritubular capillaritis, C4d deposition and transplant glomerulopathy. In this book, we systematically present the distinctive histomorphological patterns of acute cellular, antibody-mediated, chronic active and mixed rejection phenotypes, aiming to enhance reproducibility of diagnosis and inform timely, personalized immunomodulatory strategies.

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Kidney Transplant Rejection: T-Cell and Antibody-Mediated Rejection

  • 章节

  • 发表日期：

    2025年

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  • Mariam Priya Alexander,
  • Nalumackal Vijayan Seethalekshmy,
  • Radhika Krishna Patil,
  • Carrie Schinstock

摘要

Kidney allograft rejection is driven by a spectrum of immune mechanisms in which host T-cells, donor-specific antibodies and innate effectors collectively injure the graft. Acute T-cell-mediated rejection manifests histologically with interstitial mononuclear infiltrates, tubulitis, and intimal arteritis, whereas antibody-mediated rejection is characterized by microvascular inflammation, peritubular capillaritis, C4d deposition and transplant glomerulopathy. In this book, we systematically present the distinctive histomorphological patterns of acute cellular, antibody-mediated, chronic active and mixed rejection phenotypes, aiming to enhance reproducibility of diagnosis and inform timely, personalized immunomodulatory strategies.