The Basics of Renal Allograft Pathology

Megan L. Troxell, Donald C. Houghton

Research output: Contribution to journalReview article


Renal allograft biopsy provides critical information in the management of renal transplant patients, and must be analyzed in close collaboration with the clinical team. The histologic correlates of acute T-cell mediated rejection are interstitial inflammation, tubulitis, and endothelialitis; polyomavirus nephropathy is a potential mimic. Evidence of antibody-mediated rejection includes C4d deposition; morphologic acute tissue injury; and donor specific antibodies. Acute tubular injury/necrosis is a reversible cause of impaired graft function, especially in the immediate post-transplant period. Drug toxicity, recurrent disease, chronic injury, and other entities affecting both native and transplant kidneys must also be evaluated.

Original languageEnglish (US)
Pages (from-to)367-387
Number of pages21
JournalSurgical Pathology Clinics
Issue number3
StatePublished - Sep 2014


  • Antibody-mediated rejection
  • C4d
  • Kidney
  • Polyomavirus
  • T-cell-mediated rejection
  • Transplant

ASJC Scopus subject areas

  • Surgery
  • Pathology and Forensic Medicine

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