title: A surgeons' guide to renal transplant immunopathology, immunology, and immunosuppression.
abstract: The response to allografting involves adaptive and innate immune mechanisms. In the adaptive system, activated T cells differentiate to cytotoxic effectors that attack the graft and trigger B cells to differentiation to plasma cells that produce anti-HLA antibodies. The innate immune system recognizes antigens in a non-specific manner and recruits immune cells to the graft through the productions of chemotactic factors, and activation of cytokines and the complement cascade. In the kidney the tubules and the endothelium are the targets of the rejection response. Immune suppression is effective in modulating the adaptive immune system effect on graft histology.
authors.affiliation: Department of Pathology and Genomic Medicine, Houston Methodist Hospital, 6565 Fannin Street, Houston, TX 77030, USA. Electronic address: lgaber@houstonmethodist.org.
authors.forename: Lillian W
authors.initials: LW
authors.lastname: Gaber
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Knight
authors.forename: Samir J
authors.initials: SJ
authors.lastname: Patel
mesh_terms: D064591:Allografts; D001739:BK Virus; D065095:Calcineurin Inhibitors; D016207:Cytokines / Q000276:immunology; D013502:General Surgery; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology*; D007113:Immunity, Innate; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation; D027601:Polyomavirus Infections; D013601:T-Lymphocytes / Q000276:immunology; D014181:Transplantation Immunology; D014412:Tumor Virus Infections
chemical_list: D065095:Calcineurin Inhibitors; D016207:Cytokines; D007166:Immunosuppressive Agents
keywords: Adaptive immune responses; Biopsy; Graft rejection; Immune suppression