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November 2, 2021

Diagnose This (November 2, 2021)

chronic active antibody-mediated rejection

In a renal transplant recipient, these findings would be most consistent with……?

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The biopsy shows glomerulitis, capillary wall double contouring and peritubular capillaritis. These findings are consistent with chronic active antibody-mediated rejection when supported by the presence of C4d deposition along peritubular capillaries, DSAs or increased expression of gene transcripts/classifiers strongly associated with ABMR.

 

Loupy A, Haas M, Roufosse C, Naesens M, Adam B, Afrouzian M, Akalin E, Alachkar N, Bagnasco S, Becker JU, Cornell LD. The Banff 2019 Kidney Meeting Report (I): Updates on and clarification of criteria for T cell–and antibody‐mediated rejection.