Evidence-based resource for transplant immunology: rejection mechanisms, immunosuppression protocols, biomarker discovery, and clinical monitoring for transplant professionals and researchers.
Acute rejection rate (1yr)
Transplants annually (global)
Critical detection window
Understanding the immunological processes that drive acute allograft rejection
Direct and indirect allorecognition by recipient T cells leads to tubulitis, interstitial inflammation, and endothelialitis. Classified by Banff criteria (Grade IA-III).
Donor-specific antibodies (DSA) bind endothelial HLA, activating complement (C4d deposition) and causing microvascular inflammation and thrombotic microangiopathy.
Preformed antibodies cause immediate graft loss within minutes to hours. Now rare due to crossmatch testing but remains a critical contraindication to transplantation.
Triple therapy (CNI + antimetabolite + steroid) remains standard. Induction with IL-2R antibodies or thymoglobulin based on immunological risk assessment.
dd-cfDNA, gene expression profiling (Molecular Microscope), and urinary CXCL9/10 enable non-invasive rejection monitoring, reducing need for protocol biopsies.
Chronic antibody-mediated rejection remains the leading cause of late graft loss. Transplant glomerulopathy and interstitial fibrosis/tubular atrophy (IFTA) are key histological findings.
1-year kidney graft survival
Acute rejection incidence
Late loss from chronic AMR
Optimal treatment window
Comprehensive review of T-cell and antibody-mediated rejection pathways, Banff classification, and emerging understanding of mixed rejection phenotypes.
Read ArticleUpdated approaches to induction and maintenance immunosuppression, including belatacept, clazakizumab, and anti-BAFF therapies for DSA management.
Read ArticleReview of dd-cfDNA, urinary chemokines, gene expression panels, and machine learning approaches for non-invasive rejection surveillance.
Read ArticlePropose collaboration on transplant immunology research, submit findings, or request data access.
Book a discussion on transplant immunology research, clinical trial design, or biomarker validation.