New insights into rejection entities in kidney transplantation

Kidney transplant rejection continues to threaten the long-term success of kidney transplants, with microvascular inflammation (inflammation within capillaries) playing a pivotal role in graft failure. Due to its complex nature, this inflammation poses a major challenge in clinical practice. In response, the international Banff classification-;the global standard for diagnosing transplant rejection-;has redefined antibody-mediated rejection diagnostics by introducing two new categories of microvascular inflammation: mild microvascular inflammation with probable antibody-mediated rejection and microvascular inflammation in the absence of antibody-mediated responses.

In a landmark study analyzing more than 16,000 biopsies from almost 7,000 kidney transplant recipients, researchers found that many cases initially considered as non-rejection were reclassified into the newly defined categories of microvascular inflammation. Importantly, reclassified patients with microvascular inflammation in the absence of antibody-mediated responses displayed an increased risk of graft failure compared with those without signs of rejection, underscoring the importance of this new classification.

Source:

American Society of Nephrology