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Tubulointerstitial rejection of renal allografts


Authors: Jana Malušková;  Eva Honsová
Authors‘ workplace: Pracoviště klinické a transplantační patologie, Transplantcentrum IKEM
Published in: Čes.-slov. Patol., 51, 2015, No. 3, p. 113-115
Category: Reviews Article

Overview

Tubulo-intersticial rejection represents T-cell mediated rejection of kidney allografts with the morphology of immune-mediated interstitial nephritis. Diagnosis is dependent on the histopathological evaluation of a graft biopsy sample. The key morphological features are interstitial inflammatory infiltrate and damage to tubular epithelial cell which in severe cases can result in the ruptures of the tubular basement membranes.

The differential diagnosis of tubulo-interstitial rejection includes acute interstitial nephritis and viral inflammatory kidney diseases, mainly polyomavirus nephropathy.

Keywords:
kidney allograft – tubulo-interstitial rejection – T-cell mediated rejection


Sources

1. Solez K, Colvin RB, Racusen LC, Haas M, et al. Banff 07 classification of renal allograft pathology: updates and future directions. Am J Transplant 2008; 8: 753-760.

2. Haas M, Sis B, Racusen LC, et al. Banff 2013 meeting report: inclusion of C4d-negative antibody-mediated rejection and antibody-associated arterial lesions. Am J Transplant 2014; 14: 272-283.

3. Koyama I, Nadazdin O, Boskovic S, et al. Depletion of CD8 memory T cells for induction of tolerance of a previously transplanted kidney allograft. Am J Transplant 2007; 5: 1055-1061.

4. Colvin RB, Cohen AH, Saiontz C, et al. Evaluation of pathologic criteria for acute renal allograft rejection: reproducibility, sensitivity, and clinical correlation. J Am Soc Nephrol 1997; 8: 1930-1941.

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Anatomical pathology Forensic medical examiner Toxicology
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