title: [Pathological and immunological changes of renal transplant rejection: report of 56 cases].
abstract: OBJECTIVE
  To investigate the pathological and immunological changes of renal grafts in recipients experiencing graft rejection.
  
  
  METHODS
  The clinicopathologic data of 56 renal needle biopsy samples obtained from renal transplant recipients were analyzed retrospectively. The specimens were classified histopathologically according to the Banff 2009 classification system and analyzed by immunohistochemical labeling and immunofluorescence.
  
  
  RESULTS
  In the 56 recipients, 1 (1.79%) experienced hyperacute rejection, 8 (14.29%) had suspected acute rejection, 12 (21.43%) developed acute T-cell rejection, 6 (10.71%) had acute antibody-mediated rejection, 2 (3.57%) had acute T-cell rejection with acute antibody-mediated rejection, 12 (21.43%) had chronic active T cell-mediated rejection, 2 (3.57%) had chronic active antibody-mediated rejection, 2 (3.57%) had chronic active T cell-mediated rejection with antibody-mediated rejection, 8 (14.29%) had non-specific interstitial fibrosis and tubular atrophy, and 3 (5.36%) had normal graft function. The expression levels of immune markers CD3, CD4, CD8, CD20, GrB and perforin differed with the types of T cell-mediated graft rejection, and the positivity and expression levels of these markers tended to increased with the severity of graft rejection. The expression of C4d was positive in all cases with antibody-mediated graft rejection.
  
  
  CONCLUSIONS
  The pathological characteristics of the renal biopsy specimens and expression levels of the immune markers allow timely and accurate evaluation of graft rejection type to provide a reliable pathological and etiological basis for clinical treatment and prognostic assessment.
authors.affiliation: Department of Pathology, First Affiliated Hospital, Department of Oncology, Department of Kidney Transplant, Xi'an Jiaotong University College of Medicine, Xi'an 710061, China. E-mail: suiyanxi029@163.com.
authors.forename: Yanxia
authors.initials: Y
authors.lastname: Sui
authors.forename: Tao
authors.initials: T
authors.lastname: Sun
authors.forename: Dongli
authors.initials: D
authors.lastname: Zhao
authors.forename: Jun
authors.initials: J
authors.lastname: Hou
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Li
authors.forename: Zhe
authors.initials: Z
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006084:Graft Rejection / Q000276:immunology* / Q000473:pathology*; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000276:immunology / Q000473:pathology; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult