Educational Case: Renal allograft rejection

Harrison Dai; Shirui Chen; Jolanta Kowalewska

doi:10.1016/j.acpath.2022.100013

Educational Case: Renal allograft rejection

Acad Pathol. 2022 Jun 21;9(1):100013. doi: 10.1016/j.acpath.2022.100013. eCollection 2022.

Authors

Harrison Dai¹, Shirui Chen², Jolanta Kowalewska¹

Affiliations

¹ Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA, USA.
² Department of Internal Medicine, Division of Nephrology, Eastern Virginia Medical School, Norfolk, VA, USA.

Abstract

Chronic rejection, the slowest presenting form of transplant rejection, typically manifests in the timespan of months to years. The pathogenesis of chronic rejection involves either cell- or humoral-mediated processes that involve memory cells, plasma cells, and antibody production against donor antigens. The findings of chronic rejection are nonspecific and include interstitial fibrosis and tubular atrophy with associated interstitial inflammation, vascular changes characterized by thickened intima containing macrophages and lymphocytes, and transplant glomerulopathy with mesangial matrix expansion and double contour of capillary walls.⁹.

Keywords: Disease mechanisms; Human leukocyte antigen; Immune dysfunction; Immunological mechanisms; Pathology competencies; Rejection; Transplantation.