The Basics of Renal Allograft Pathology

Megan L. Troxell, Donald C. Houghton

Research output: Contribution to journalReview articlepeer-review


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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