Skip to main content
WoMWeb of Medicine
SearchGraphHistory
Nephrology›Condition·Updated Jul 11, 2026·v1

Kidney Transplant Rejection

Kidney transplant rejection is a major cause of graft loss, classified by timing and mechanism into hyperacute, acute TCMR, acute ABMR, and chronic rejection. Diagnosis relies on biopsy with Banff classification, supported by noninvasive biomarkers like dd-cfDNA and urinary chemokines. Acute TCMR is treated with corticosteroids; ABMR with TPE and IVIG; hyperacute rejection requires graft nephrectomy. Long-term management includes optimizing maintenance immunosuppression (e.g., belatacept conversion), addressing nonadherence, and managing comorbidities. Bortezomib is ineffective for late ABMR; clazakizumab is investigational. Prognosis is worst with dnDSA, late rejection, and vascular involvement.

Moderate Evidence109 references·1,964 words·8 min read·v1
nephrologytransplantrejectionimmunologykidney

Quick Reference

RxDrug of choiceFor acute TCMR: IV methylprednisolone 250-500 mg/day x3 days. For acute ABMR: therapeutic plasma exchange (5-6 sessions) + IVIG 0.4 g/kg/day x5 days.
AltAlternativesAnti-thymocyte globulin (Thymoglobulin) for steroid-resistant TCMR; rituximab for refractory ABMR; clazakizumab (investigational) for late ABMR; belatacept for CNI conversion.
⊘AvoidBortezomib for late ABMR (ineffective per BORTEJECT); NSAIDs; non-dihydropyridine CCBs (diltiazem, verapamil) may exacerbate CNI toxicity; mycophenolate and mTOR inhibitors in pregnancy.
DxTest of choiceRenal allograft biopsy with Banff classification (including C4d and molecular testing if available).
ScKey scoreBanff histologic grade (e.g., borderline, IA, IB, IIA, IIB, III for TCMR; cg, ptc, g for ABMR).
→When to referAcute or chronic rejection not responding to first-line therapy; suspected ICI-induced rejection; BK virus nephropathy; cost-related nonadherence requiring social work.
Identify rejection type promptly via biopsy; treat TCMR with steroids, ABMR with TPE/IVIG, and hyperacute rejection with graft nephrectomy; address nonadherence as a key modifiable factor.
Kidney transplant rejection is an immunologic process where the recipient's immune system attacks the allograft, classified by timing and mechanism into hyperacute, acute T-cell-mediated (TCMR), acute antibody-mediated (ABMR), and chronic rejection. Rejection is the leading cause of graft loss after the first year, with ABMR particularly resistant to therapy. Early detection and appropriate management are critical for graft survival.

Overview and Recommendations

Background

  • •Kidney transplant rejection is an immune-mediated injury to the renal allograft, driven by recipient T cells (TCMR) or donor-specific antibodies (ABMR), and classified by onset: hyperacute (minutes to hours), acute TCMR/ABMR (days to weeks), and chronic rejection (months to years). Hyperacute rejection, now rare due to pre-transplant crossmatching, is caused by preformed antibodies and leads to immediate graft loss if not removed. Acute TCMR accounts for a substantial proportion of early rejection episodes, with rates falling but still ~10-15% in modern cohorts, while ABMR, particularly late-onset, is the dominant cause of graft failure after the first year.
  • •The incidence of acute rejection ranges from 1-21% depending on cohort and definition; in the ANZDATA Registry (1997-2004), 1961 episodes occurred among 4325 grafts. Despite a one-third reduction in crude rejection rates over that period, long-term graft survival has not improved proportionally, highlighting the persistent impact of late and antibody-mediated injury. De novo donor-specific antibodies (dnDSA) are the strongest predictor of graft loss: graft survival 87.1% versus 97.8% in dnDSA-negative recipients (p=0.007).
  • •The Banff classification is the histologic gold standard, grading TCMR by tubulitis (t) and intimal arteritis (v), and ABMR by microvascular inflammation (g, ptc), C4d deposition, and transplant glomerulopathy (cg). The KDIGO guideline endorses this system and stratifies treatment intensity: corticosteroids for borderline/IA-IIB TCMR, and lymphocyte-depleting agents for steroid-resistant or severe (IIB-III) cases. Molecular diagnostics (e.g., NanoString, RT-MLPA) are increasingly used to refine classification, particularly in mixed or ambiguous cases.
  • •Risk factors for rejection span recipient (HLA mismatch, nonadherence, preformed DSA, psoriasis), donor (deceased donor, ischemia time), and transplant-related (BK virus, CNI toxicity). Cost-related nonadherence is a major modifiable factor: 68% of US transplant programs report deaths or graft losses attributable to it. The interplay between alloimmunity and viral reactivation (CMV, EBV, BKV) complicates management, as immunosuppression reduction to treat infection may trigger rejection.

Evaluation

  • •Suspect kidney transplant rejection when a patient presents with a rise in serum creatinine of ≥0.3 mg/dL or ≥25% from baseline, particularly within the first months post-transplant. The classic triad of fever, graft tenderness, and oliguria is now rare; most rejecting patients are asymptomatic and identified through routine monitoring.
  • •Ask about medication adherence, recent changes in immunosuppression (e.g., dose reductions, switches), symptoms of infection (fever, dysuria), and exposure to nephrotoxic agents (NSAIDs, contrast). Also inquire about non-adherence due to cost, as this is a leading preventable cause.
  • •Examine for graft tenderness, swelling, or warmth; check for new or worsening hypertension, edema, and signs of fluid overload. In hyperacute rejection, the graft may appear mottled, cyanotic, and anuric intraoperatively.
  • •Order serum creatinine and eGFR trajectory as the cornerstone of monitoring. A 25% rise from baseline should trigger further investigation. Measure donor-specific antibodies (DSA) using single-antigen bead assays to support ABMR diagnosis, but note that up to 46% of ABMR cases are DSA-negative by conventional assays.
  • •Order donor-derived cell-free DNA (dd-cfDNA) as a noninvasive biomarker: a threshold >0.5% is independently associated with ABMR (OR 21.9) and TCMR (OR 5.37). For TCMR, urinary CXCL9/CXCL10 integrated with clinical markers (eGFR, DSA, polyoma viremia) achieves an AUC of 0.81 and can avoid 59 protocol biopsies per 100 patients when predicted risk is below 10%.
  • •Perform a renal allograft biopsy for definitive diagnosis and classification according to Banff criteria. Biopsy is indicated for-cause when creatinine rises, DSA appear, or noninvasive biomarkers are positive. Protocol biopsies at 3, 6, and 12 months are common in many centers to detect subclinical rejection.
  • •Diagnostic criteria include: for acute TCMR, tubulitis (t) and intimal arteritis (v); for acute ABMR, microvascular inflammation (g+ptc ≥2), C4d deposition in peritubular capillaries (or C4d-negative with microvascular injury), and positive DSA. Chronic active ABMR requires transplant glomerulopathy (cg) and/or peritubular capillary basement membrane multilayering.
  • •Also consider alternative diagnoses: calcineurin inhibitor nephrotoxicity, BK polyomavirus nephropathy (check BKV PCR), recurrent or de novo glomerulonephritis, and acute tubular necrosis. In patients on immune checkpoint inhibitors (e.g., nivolumab), rejection can be unmasked; dd-cfDNA may rise dramatically before clinical deterioration.
  • •Assess viral status: order CMV, EBV, and BKV PCRs, as active viremia is common (CMV in 18%, EBV in 7%, BKV in 5% of suspected rejection episodes) and can mimic or precipitate rejection. BK virus-specific cytotoxic T lymphocytes may be considered for treatment if BKV nephropathy is confirmed.

Management

  • •For acute TCMR (Banff borderline to grade IIB), initiate high-dose intravenous corticosteroids: methylprednisolone 250-500 mg/day for 3 consecutive days, followed by a rapid oral taper over 2-4 weeks. Monitor creatinine daily; if no improvement in 5-7 days, escalate to lymphocyte-depleting therapy.
  • •For steroid-resistant or severe TCMR (grade IIB or III), administer rabbit anti-thymocyte globulin (Thymoglobulin) at 1.5 mg/kg IV daily for 5-7 days, adjusted for lymphocyte count. Premedicate with acetaminophen, antihistamine, and corticosteroids to reduce infusion reactions. Monitor for thrombocytopenia, leukopenia, and infection.
  • •For acute ABMR, initiate therapeutic plasma exchange (TPE) as first-line therapy (ASFA Category I). Perform 5-6 sessions over 10-14 days, using albumin as replacement fluid (84% of sessions) or fresh frozen plasma if coagulopathic. Adverse events include hypotension, hypocalcemia, and facial edema (5.88% of procedures).
  • •Administer intravenous immunoglobulin (IVIG) 0.4 g/kg/day for 5 days (or 2 g/kg divided) as adjunct to TPE. IVIG neutralizes circulating DSA and modulates complement. For refractory ABMR, consider rituximab 375 mg/m² IV weekly for 4 weeks, though evidence is limited.
  • •For hyperacute rejection, immediate graft nephrectomy is the only option; no medical therapy is effective. Explain to the patient that the graft is nonviable and removal is necessary to prevent systemic complications.
  • •For late ABMR, do not use bortezomib (1.3 mg/m² IV on days 1,4,8,11), the BORTEJECT trial showed no benefit in eGFR slope, graft survival, or DSA reduction, and it caused gastrointestinal and hematologic toxicity. Instead, consider investigational clazakizumab 25 mg SC every 4 weeks (monitor for infections, diverticulitis).
  • •For patients with CNI nephrotoxicity or high DSA risk, consider conversion from CNI to belatacept-based maintenance: belatacept 5 mg/kg IV every 4 weeks. This improves eGFR (55.5 vs 48.5 mL/min/1.73 m² at 24 months) and reduces de novo DSA (1% vs 7%), but increases biopsy-proven acute rejection (8% vs 4%).
  • •Address cost-related medication nonadherence proactively: screen for financial barriers, connect patients with assistance programs (e.g., Medicare Part D, manufacturer patient assistance), and consider lifetime immunosuppressant coverage advocacy. Up to 68% of programs report graft losses from nonadherence.
  • •Monitor for complications: check CMV surveillance (reactivation risk increased by lymphocyte-depleting agents), manage hypertension (target <130/80 mmHg with amlodipine or diltiazem, avoiding nondihydropyridine CCBs?), and start statin therapy (atorvastatin 10-20 mg daily) for all transplant recipients regardless of LDL-C.
  • •Avoid NSAIDs, iodinated contrast without adequate hydration, and nephrotoxic drugs. For patients with atrial fibrillation, prefer direct oral anticoagulants (e.g., apixaban) over vitamin K antagonists (HR 0.66 for composite outcome).
  • •When to refer: to transplant nephrology for any acute rejection episode; to oncology for ICI-induced rejection; to infectious disease for BK virus or CMV management; to social work for adherence support.
  • •Discharge criteria after acute rejection treatment: stable or improving creatinine, resolution of symptoms, negative DSA trend, and no active infection. Arrange close outpatient follow-up with weekly labs for 1 month, then per protocol.

Board Review — High Yield

  • •Hyperacute rejection, Presents within minutes to hours of reperfusion; caused by preformed antibodies; requires immediate graft nephrectomy.
  • •DSA-negative ABMR, Up to 46% of ABMR cases lack detectable DSA by conventional assays but have identical prognosis; consider non-HLA antibodies (e.g., AT1R).
  • •Bortezomib, Ineffective for late ABMR in the BORTEJECT trial; no benefit on eGFR slope or graft survival.
  • •Clazakizumab, Anti-IL-6 antibody shows promise in late ABMR (slower eGFR decline) but is investigational with infection risk.
  • •Belatacept conversion, Improves eGFR and reduces de novo DSA but increases BPAR (8% vs 4%); consider for CNI toxicity.
  • •Cost-related nonadherence, 68% of US transplant programs report deaths/graft losses; screen and address barriers.
  • •Banff classification, Gold standard for grading rejection; defines TCMR by tubulitis (t) and intimal arteritis (v); ABMR by microvascular inflammation (g, ptc), C4d, and cg.
  • •dd-cfDNA >0.5%, Associated with ABMR (OR 21.9) and TCMR (OR 5.37); high NPV for ruling out ABMR.
  • •Urinary CXCL9/CXCL10, Integrated model with clinical markers achieves AUC 0.81 for acute rejection; can avoid 59 protocol biopsies per 100 patients.
  • •BK virus nephropathy, Treat with reduced immunosuppression and consider BK virus-specific CTLs; associated with late TCMR and ABMR.

Deep Dive — Evidence Details

References

  1. [1]

    Bamoulid J, Staeck O, Halleck F et al.. “Advances in pharmacotherapy to treat kidney transplant rejection.” Expert opinion on pharmacotherapy (2015). PMID: 26159444 ↗

    L5REVIEW_NARRATIVECited in: Definition, Classification and Nomenclature
  2. [2]

    Di Giacomo AM, Guarnieri A, Tripodi SA et al.. “Brief Communication PD1-related Nephrotoxicity: Optimizing Its Clinical Management Through Histopathologic Features.” Journal of immunotherapy (Hagerstown, Md. : 1997) (2022). PMID: 35132002 ↗

    L4OTHERCited in: Definition, Classification and Nomenclature, Acute Management
  3. [3]

    Massicotte-Azarniouch D, Sood MM, Fergusson DA et al.. “Validation of the International Classification of Disease 10th Revision Codes for Kidney Transplant Rejection and Failure.” Canadian journal of kidney health and disease (2020). PMID: 33403117 ↗

    L2OTHERCited in: Definition, Classification and Nomenclature
  4. [4]

    Van Loon E, Naesens M. “Blood transcriptomics as non-invasive marker for kidney transplant rejection.” Nephrologie & therapeutique (2021). PMID: 33910703 ↗

    L5REVIEW_NARRATIVECited in: Definition, Classification and Nomenclature
  5. [5]

    Spiridon C, Hunt J, Mack M et al.. “Evaluation of soluble CD30 as an immunologic marker in heart transplant recipients.” Transplantation proceedings (2006). PMID: 17175368 ↗

    L2OTHERCited in: Definition, Classification and Nomenclature
  6. [6]

    Eskandary F, Regele H, Baumann L et al.. “A Randomized Trial of Bortezomib in Late Antibody-Mediated Kidney Transplant Rejection.” Journal of the American Society of Nephrology : JASN (2017). PMID: 29242250 ↗

    L1RCTCited in: Pathophysiology and Mechanism, Clinical Presentation, Diagnosis and Workup, Long-term and Definitive Management, Renal Replacement Therapy, Dialysis Access & Transplantation, History and Evolution of Treatment, Complications (Chronic Systemic Sequelae), Prognosis and Natural History, Special Populations & Pregnancy
  7. [7]

    Doberer K, Duerr M, Halloran PF et al.. “A Randomized Clinical Trial of Anti-IL-6 Antibody Clazakizumab in Late Antibody-Mediated Kidney Transplant Rejection.” Journal of the American Society of Nephrology : JASN (2020). PMID: 33443079 ↗

    L1RCTCited in: Pathophysiology and Mechanism, Diagnosis and Workup, Long-term and Definitive Management, Renal Replacement Therapy, Dialysis Access & Transplantation, History and Evolution of Treatment, Prognosis and Natural History, Special Populations & Pregnancy
  8. [8]

    Rekers NV, Bajema IM, Mallat MJ et al.. “Beneficial Immune Effects of Myeloid-Related Proteins in Kidney Transplant Rejection.” American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2016). PMID: 26607974 ↗

    L2RCTCited in: Pathophysiology and Mechanism, Epidemiology, Etiology and Risk Factors, Diagnosis and Workup, Long-term and Definitive Management, Renal Replacement Therapy, Dialysis Access & Transplantation, History and Evolution of Treatment, Prognosis and Natural History, Special Populations & Pregnancy
  9. [9]

    Wang S, Diao H, Guan Q et al.. “Decreased renal ischemia-reperfusion injury by IL-16 inactivation.” Kidney international (2007). PMID: 18004294 ↗

    L5OTHERCited in: Pathophysiology and Mechanism, Complications (Chronic Systemic Sequelae)
  10. [10]

    Nakorchevsky A, Hewel JA, Kurian SM et al.. “Molecular mechanisms of chronic kidney transplant rejection via large-scale proteogenomic analysis of tissue biopsies.” Journal of the American Society of Nephrology : JASN (2010). PMID: 20093355 ↗

    L4OTHERCited in: Pathophysiology and Mechanism, Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  11. [11]

    Delville M, Lamarthée B, Pagie S et al.. “Early Acute Microvascular Kidney Transplant Rejection in the Absence of Anti-HLA Antibodies Is Associated with Preformed IgG Antibodies against Diverse Glomerular Endothelial Cell Antigens.” Journal of the American Society of Nephrology : JASN (2019). PMID: 30850439 ↗

    L3OTHERCited in: Pathophysiology and Mechanism, Renal Replacement Therapy, Dialysis Access & Transplantation, Complications (Chronic Systemic Sequelae), Special Populations & Pregnancy
  12. [12]

    Agrawal R, Waller JL, Baer SL et al.. “Psoriasis associates with increased risk for kidney transplant rejection.” Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (2025). PMID: 40145136 ↗

    L2OTHERCited in: Pathophysiology and Mechanism, Epidemiology, Etiology and Risk Factors, Renal Replacement Therapy, Dialysis Access & Transplantation, Complications (Chronic Systemic Sequelae), Prognosis and Natural History, Special Populations & Pregnancy
  13. [13]

    Elshafie M, Furness PN. “Identification of lesions indicating rejection in kidney transplant biopsies: tubulitis is severely under-detected by conventional microscopy.” Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (2011). PMID: 21862457 ↗

    L4OTHERCited in: Pathophysiology and Mechanism, Clinical Presentation, Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  14. [14]

    Hidalgo LG, Madill-Thomsen KS, Reeve J et al.. “Improving the histologic detection of donor-specific antibody-negative antibody-mediated rejection in kidney transplants.” American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2025). PMID: 40854490 ↗

    L4OTHERCited in: Pathophysiology and Mechanism, Epidemiology, Etiology and Risk Factors, Clinical Presentation, Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation, Prognosis and Natural History, Special Populations & Pregnancy
  15. [15]

    Halloran PF, Merino Lopez M, Barreto Pereira A. “Identifying Subphenotypes of Antibody-Mediated Rejection in Kidney Transplants.” American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2016). PMID: 26743766 ↗

    L2OTHERCited in: Pathophysiology and Mechanism, Epidemiology, Etiology and Risk Factors, Clinical Presentation, Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation, Prognosis and Natural History, Special Populations & Pregnancy
  16. [16]

    Einecke G, Fairhead T, Hidalgo LG et al.. “Tubulitis and epithelial cell alterations in mouse kidney transplant rejection are independent of CD103, perforin or granzymes A/B.” American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2006). PMID: 16869802 ↗

    L5OTHERCited in: Pathophysiology and Mechanism, Renal Replacement Therapy, Dialysis Access & Transplantation
  17. [17]

    Chen B, Kapturczak MH, Joseph R et al.. “Adeno-associated viral vector-mediated interleukin-10 prolongs allograft survival in a rat kidney transplantation model.” American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2007). PMID: 17456199 ↗

    L5OTHERCited in: Pathophysiology and Mechanism, History and Evolution of Treatment, Prognosis and Natural History
  18. [18]

    Mitsui Y, Sadahira T, Araki M et al.. “Clinical impact of abdominal fat distribution measured by 3-D computed tomography volumetry on post-transplant renal function in recipients after living kidney transplantation: a retrospective study.” Clinical and experimental nephrology (2018). PMID: 30191414 ↗

    L2COHORTCited in: Pathophysiology and Mechanism, Epidemiology, Etiology and Risk Factors, Clinical Presentation, Diagnosis and Workup, Prognosis and Natural History
  19. [19]

    Guzzo I, Morolli F, Camassei FD et al.. “Acute kidney transplant rejection mediated by angiotensin II type 1 receptor antibodies in a pediatric hyperimmune patient.” Pediatric nephrology (Berlin, Germany) (2016). PMID: 27752765 ↗

    L4CASE_REPORTCited in: Pathophysiology and Mechanism, Long-term and Definitive Management
  20. [20]

    Kanbay M, Mizrak B, Copur S et al.. “Targeting IL-6 in antibody-mediated kidney transplant rejection.” Clinical kidney journal (2025). PMID: 40357502 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology and Mechanism
  21. [21]

    van Vugt LK, Schagen MR, de Weerd A et al.. “Investigational drugs for the treatment of kidney transplant rejection.” Expert opinion on investigational drugs (2022). PMID: 36175360 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology and Mechanism
  22. [22]

    Rogulska K, Wojciechowska-Koszko I, Dołęgowska B et al.. “The Most Promising Biomarkers of Allogeneic Kidney Transplant Rejection.” Journal of immunology research (2022). PMID: 35669103 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology and Mechanism
  23. [23]

    Terinte-Balcan G, Lebraud E, Zuber J et al.. “Deciphering the Complexity of the Immune Cell Landscape in Kidney Allograft Rejection.” Transplant international : official journal of the European Society for Organ Transplantation (2024). PMID: 39722854 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology and Mechanism
  24. [24]

    Mayer KA, Budde K, Schatzl M et al.. “CD38 monoclonal antibody felzartamab for late antibody-mediated rejection: a phase II drug evaluation.” Expert opinion on investigational drugs (2025). PMID: 39925214 ↗

    L5REVIEW_NARRATIVECited in: Pathophysiology and Mechanism
  25. [25]

    Hotta K. “Clinical Trials for Developing Treatment and Early Diagnostic Methods for Chronic Active Antibody-Mediated Rejection in Kidney Transplantation: A Review.” Nephron (2025). PMID: 40763710 ↗

    L5TRIAL_NONRANDOMCited in: Pathophysiology and Mechanism, Renal Replacement Therapy, Dialysis Access & Transplantation
  26. [26]

    Budde K, Prashar R, Haller H et al.. “Conversion from Calcineurin Inhibitor- to Belatacept-Based Maintenance Immunosuppression in Renal Transplant Recipients: A Randomized Phase 3b Trial.” Journal of the American Society of Nephrology : JASN (2021). PMID: 34706967 ↗

    L1RCTCited in: Epidemiology, Etiology and Risk Factors, Long-term and Definitive Management, Renal Replacement Therapy, Dialysis Access & Transplantation, History and Evolution of Treatment, Prognosis and Natural History, Special Populations & Pregnancy
  27. [27]

    Flechner SM, Mulgoankar S, Melton LB et al.. “First-in-human study of the safety and efficacy of TOL101 induction to prevent kidney transplant rejection.” American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2014). PMID: 24751150 ↗

    L4TRIAL_NONRANDOMCited in: Epidemiology, Etiology and Risk Factors, Renal Replacement Therapy, Dialysis Access & Transplantation, History and Evolution of Treatment, Special Populations & Pregnancy
  28. [28]

    van der Zwan M, Baan CC, van Gelder T et al.. “Review of the Clinical Pharmacokinetics and Pharmacodynamics of Alemtuzumab and Its Use in Kidney Transplantation.” Clinical pharmacokinetics (2018). PMID: 28669130 ↗

    L2SR_OBSCited in: Epidemiology, Etiology and Risk Factors, Long-term and Definitive Management, Prognosis and Natural History
  29. [29]

    Pagliazzi A, Wellekens K, de Loor H et al.. “Clinical Relevance of Donor-Derived cfDNA In Monitoring Kidney Transplant Rejection.” Journal of the American Society of Nephrology : JASN (2026). PMID: 42133430 ↗

    L2OTHERCited in: Epidemiology, Etiology and Risk Factors
  30. [30]

    Vaulet T, Divard G, Thaunat O et al.. “Data-driven Derivation and Validation of Novel Phenotypes for Acute Kidney Transplant Rejection using Semi-supervised Clustering.” Journal of the American Society of Nephrology : JASN (2021). PMID: 33687976 ↗

    L2OTHERCited in: Epidemiology, Etiology and Risk Factors, Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  31. [31]

    Jung S, Kim H, Kwon H et al.. “Parathyroidectomy versus cinacalcet in the treatment of tertiary hyperparathyroidism after kidney transplantation: a retrospective study.” Kidney research and clinical practice (2022). PMID: 35286788 ↗

    L3COHORTCited in: Epidemiology, Etiology and Risk Factors
  32. [32]

    Verhoeven JGHP, Baan CC, Peeters AMA et al.. “Circulating cell-free nucleosomes as biomarker for kidney transplant rejection: a pilot study.” Clinical epigenetics (2021). PMID: 33573704 ↗

    L2RCTCited in: Epidemiology, Etiology and Risk Factors, Clinical Presentation, Diagnosis and Workup, Long-term and Definitive Management, History and Evolution of Treatment
  33. [33]

    Evans RW, Applegate WH, Briscoe DM et al.. “Cost-related immunosuppressive medication nonadherence among kidney transplant recipients.” Clinical journal of the American Society of Nephrology : CJASN (2010). PMID: 20847093 ↗

    L4OTHERCited in: Epidemiology, Etiology and Risk Factors, Long-term and Definitive Management, Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  34. [34]

    Mesgar Saravi N, Mousavi T. “Seroprevalence of Cytomegalovirus antibodies and primary infection among hemodialysis patients: A systematic and meta-analysis review.” Transplant immunology (2022). PMID: 35339658 ↗

    L4SR_OBSCited in: Epidemiology, Etiology and Risk Factors, Acute Management, Prognosis and Natural History
  35. [35]

    Hart A, Singh D, Brown SJ et al.. “Incidence, risk factors, treatment, and consequences of antibody-mediated kidney transplant rejection: A systematic review.” Clinical transplantation (2021). PMID: 33864724 ↗

    L2SR_OBSCited in: Epidemiology, Etiology and Risk Factors
  36. [36]

    Goldfarb-Rumyantzev AS, Shihab F, Emerson L et al.. “A population-based assessment of the familial component of acute kidney allograft rejection.” Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (2009). PMID: 19286691 ↗

    L3OTHERCited in: Epidemiology, Etiology and Risk Factors, Renal Replacement Therapy, Dialysis Access & Transplantation, Prognosis and Natural History, Special Populations & Pregnancy
  37. [37]

    Herrmann SM, Gertz MA, Stegall MD et al.. “Long-term outcomes of patients with light chain amyloidosis (AL) after renal transplantation with or without stem cell transplantation.” Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (2011). PMID: 21543655 ↗

    L4OTHERCited in: Epidemiology, Etiology and Risk Factors, Renal Replacement Therapy, Dialysis Access & Transplantation, Prognosis and Natural History, Special Populations & Pregnancy
  38. [38]

    Liu W, Zhao J, Kang ZY et al.. “De novo donor-specific HLA antibodies reduce graft survival rates and increase the risk of kidney transplant rejection: A single-center retrospective study.” Transplant immunology (2021). PMID: 34147608 ↗

    L3COHORTCited in: Epidemiology, Etiology and Risk Factors, Prognosis and Natural History
  39. [39]

    Hou W, Huang Z, Ji Z et al.. “Human leukocyte antigen-G-14-base-pair-insertion/deletion polymorphism and graft survival in kidney transplant recipients.” Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation (2014). PMID: 24702138 ↗

    L3SR_OBSCited in: Epidemiology, Etiology and Risk Factors, Staging and Risk Stratification (KDIGO)
  40. [40]

    McDonald S, Russ G, Campbell S et al.. “Kidney transplant rejection in Australia and New Zealand: relationships between rejection and graft outcome.” American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2007). PMID: 17359502 ↗

    L2OTHERCited in: Epidemiology, Etiology and Risk Factors, Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation, Complications (Chronic Systemic Sequelae), Prognosis and Natural History, Special Populations & Pregnancy
  41. [41]

    Weng SC, Shu KH, Wu MJ et al.. “Expression of decoy receptor 3 in kidneys is associated with allograft survival after kidney transplant rejection.” Scientific reports (2015). PMID: 26335204 ↗

    L2RCTCited in: Epidemiology, Etiology and Risk Factors, Long-term and Definitive Management, Prognosis and Natural History
  42. [42]

    Van Loon E, Tinel C, de Loor H et al.. “Automated Urinary Chemokine Assays for Noninvasive Detection of Kidney Transplant Rejection: A Prospective Cohort Study.” American journal of kidney diseases : the official journal of the National Kidney Foundation (2023). PMID: 37777058 ↗

    L2COHORTCited in: Clinical Presentation, Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation, History and Evolution of Treatment, Special Populations & Pregnancy
  43. [43]

    Callemeyn J, Lamarthée B, Koenig A et al.. “Allorecognition and the spectrum of kidney transplant rejection.” Kidney international (2021). PMID: 34915041 ↗

    L5REVIEW_NARRATIVECited in: Clinical Presentation, Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  44. [44]

    Loupy A, Mengel M, Haas M. “Thirty years of the International Banff Classification for Allograft Pathology: the past, present, and future of kidney transplant diagnostics.” Kidney international (2021). PMID: 34922989 ↗

    L5REVIEW_NARRATIVECited in: Clinical Presentation, Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation, History and Evolution of Treatment, Special Populations & Pregnancy
  45. [45]

    Udomkarnjananun S, Kerr SJ, Francke MI et al.. “A systematic review and meta-analysis of enzyme-linked immunosorbent spot (ELISPOT) assay for BK polyomavirus immune response monitoring after kidney transplantation.” Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology (2021). PMID: 33979739 ↗

    L2SR_OBSCited in: Clinical Presentation, Diagnosis and Workup
  46. [46]

    Cardoso de Aguiar R, Willicombe M, Roufosse C. “Noninvasive Diagnosis of Kidney Allograft Rejection.” Journal of the American Society of Nephrology : JASN (2025). PMID: 40768292 ↗

    L5REVIEW_NARRATIVECited in: Clinical Presentation, Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy, Prevention, Screening & Surveillance
  47. [47]

    Hughes AD, Lakkis FG, Oberbarnscheidt MH. “Four-Dimensional Imaging of T Cells in Kidney Transplant Rejection.” Journal of the American Society of Nephrology : JASN (2018). PMID: 29654214 ↗

    L5OTHERCited in: Clinical Presentation, Diagnosis and Workup
  48. [48]

    Zhang H, Haun RS, Collin F et al.. “Development and Validation of a Multiclass Model Defining Molecular Archetypes of Kidney Transplant Rejection: A Large Cohort Study of the Banff Human Organ Transplant Gene Expression Panel.” Laboratory investigation; a journal of technical methods and pathology (2023). PMID: 38092179 ↗

    L3COHORTCited in: Clinical Presentation, Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  49. [49]

    de Nattes T, Beadle J, Toulza F et al.. “A Simple Molecular Tool for the Assessment of Kidney Transplant Biopsies.” Clinical journal of the American Society of Nephrology : CJASN (2023). PMID: 36723289 ↗

    L4OTHERCited in: Clinical Presentation, Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  50. [50]

    Xie P, Tao M, Peng K et al.. “Plasmapheresis Therapy in Kidney Transplant Rejection.” Blood purification (2018). PMID: 30253400 ↗

    L5SR_OBSCited in: Clinical Presentation, Diagnosis and Workup
  51. [51]

    Halloran PF, Venner JM, Famulski KS. “Comprehensive Analysis of Transcript Changes Associated With Allograft Rejection: Combining Universal and Selective Features.” American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2017). PMID: 28101959 ↗

    L3OTHERCited in: Clinical Presentation, Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation
  52. [52]

    Bestard O, Augustine J, Wee A et al.. “Prospective observational study to validate a next-generation sequencing blood RNA signature to predict early kidney transplant rejection.” American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2023). PMID: 38152017 ↗

    L2OTHERCited in: Clinical Presentation, Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy, Prevention, Screening & Surveillance
  53. [53]

    Xing Y, Guo Q, Wang C et al.. “Donor-derived cell-free DNA as a diagnostic marker for kidney-allograft rejection: A systematic review and meta-analysis.” Biomolecules & biomedicine (2024). PMID: 38386614 ↗

    L1SR_OBSCited in: Clinical Presentation, Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  54. [54]

    Cho H, Nam H, Kim HE et al.. “Gut microbiome and metabolite signatures for predicting acute kidney transplant rejection: a prospective study.” Scientific reports (2025). PMID: 41461744 ↗

    L2COHORTCited in: Clinical Presentation, Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  55. [55]

    Hurkmans DP, Verhoeven JGHP, de Leur K et al.. “Donor-derived cell-free DNA detects kidney transplant rejection during nivolumab treatment.” Journal for immunotherapy of cancer (2019). PMID: 31300068 ↗

    L4CASE_REPORTCited in: Clinical Presentation, Diagnosis and Workup, Long-term and Definitive Management, Complications (Chronic Systemic Sequelae), Prevention, Screening & Surveillance
  56. [56]

    Kurian SM, Williams AN, Gelbart T et al.. “Molecular classifiers for acute kidney transplant rejection in peripheral blood by whole genome gene expression profiling.” American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2014). PMID: 24725967 ↗

    L3RCTCited in: Diagnosis and Workup, Long-term and Definitive Management, Renal Replacement Therapy, Dialysis Access & Transplantation, History and Evolution of Treatment, Complications (Chronic Systemic Sequelae), Prognosis and Natural History, Special Populations & Pregnancy
  57. [57]

    Vaulet T, Lamarthée B, Callemeyn J et al.. “Intragraft clonal expansion of cytotoxic CD8+ and CD4+ T cells in antibody-mediated kidney transplant rejection.” Kidney international (2026). PMID: 42034201 ↗

    L3OTHERCited in: Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  58. [58]

    Hu M, Wang YM, Wang Y et al.. “Regulatory T cells in kidney disease and transplantation.” Kidney international (2016). PMID: 27263492 ↗

    L5REVIEW_NARRATIVECited in: Diagnosis and Workup, Long-term and Definitive Management, Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  59. [59]

    Raffetseder U, Rauen T, Djudjaj S et al.. “Differential regulation of chemokine CCL5 expression in monocytes/macrophages and renal cells by Y-box protein-1.” Kidney international (2008). PMID: 18800033 ↗

    L5OTHERCited in: Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  60. [60]

    van der Zwan M, Hesselink DA, Clahsen-van Groningen MC et al.. “Targeted Proteomic Analysis Detects Acute T Cell-Mediated Kidney Allograft Rejection in Belatacept-Treated Patients.” Therapeutic drug monitoring (2019). PMID: 30883517 ↗

    L3RCTCited in: Diagnosis and Workup, Long-term and Definitive Management, History and Evolution of Treatment
  61. [61]

    Venner JM, Hidalgo LG, Famulski KS et al.. “The molecular landscape of antibody-mediated kidney transplant rejection: evidence for NK involvement through CD16a Fc receptors.” American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2015). PMID: 25787894 ↗

    L3OTHERCited in: Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation
  62. [62]

    Fantus D, Balshaw R, Saw CL et al.. “Diagnostic Potential of Urine CXCL10 and Donor-Derived cfDNA in Kidney Transplant Rejection.” Transplant international : official journal of the European Society for Organ Transplantation (2026). PMID: 41970280 ↗

    L3OTHERCited in: Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  63. [63]

    Kania D, Fochtman D, Skoczylas Ł et al.. “Biopsy proteome-based classification of T cell-mediated kidney allograft rejection.” Journal of translational medicine (2025). PMID: 41121127 ↗

    L3OTHERCited in: Diagnosis and Workup, Renal Replacement Therapy, Dialysis Access & Transplantation
  64. [64]

    Bestard O, Thaunat O, Bellini MI et al.. “Alloimmune Risk Stratification for Kidney Transplant Rejection.” Transplant international : official journal of the European Society for Organ Transplantation (2022). PMID: 35669972 ↗

    L5OTHERCited in: Staging and Risk Stratification (KDIGO)
  65. [65]

    Koshy P, Furian L, Nickerson P et al.. “European Survey on Clinical Practice of Detecting and Treating T-Cell Mediated Kidney Transplant Rejection.” Transplant international : official journal of the European Society for Organ Transplantation (2024). PMID: 38699173 ↗

    L5OTHERCited in: Staging and Risk Stratification (KDIGO)
  66. [66]

    Pascual J, Berger SP, Chadban SJ et al.. “Evidence-based practice: Guidance for using everolimus in combination with low-exposure calcineurin inhibitors as initial immunosuppression in kidney transplant patients.” Transplantation reviews (Orlando, Fla.) (2019). PMID: 31377099 ↗

    L5REVIEW_NARRATIVECited in: Staging and Risk Stratification (KDIGO)
  67. [67]

    Wang W, Haider CG, Wang Y et al.. “Donor-derived cell-free DNA-based liquid biopsies to determine future kidney transplant rejection.” Kidney research and clinical practice (2024). PMID: 39384354 ↗

    L5OTHERCited in: Acute Management
  68. [68]

    Kilić P, Ikić L, Mayer M et al.. “Safe and Efficient Use of Tocilizumab in Rheumatoid Arthritis Patient on Maintenance Hemodialysis: A Case Report.” Medicina (Kaunas, Lithuania) (2023). PMID: 37763636 ↗

    L4CASE_REPORTCited in: Acute Management
  69. [69]

    Miranda DM, Coelho MVP, Delamain MT et al.. “Therapeutic Plasma Exchange: Analysis of Practices and Compliance With International Guidelines.” Journal of clinical apheresis (2025). PMID: 40247606 ↗

    L4OTHERCited in: Acute Management
  70. [70]

    Bergström M, Joly AL, Seiron P et al.. “Immunological profiling of haemodialysis patients and young healthy individuals with implications for clinical regulatory T cell sorting.” Scandinavian journal of immunology (2015). PMID: 25737071 ↗

    L3OTHERCited in: Acute Management
  71. [71]

    Li J, Qi G, Tu G et al.. “Gene Therapy in Kidney Transplantation: Evidence of Efficacy and Future Directions.” Current gene therapy (2017). PMID: 29446736 ↗

    L5REVIEW_NARRATIVECited in: Acute Management
  72. [72]

    Lum EL, Huang E, Bunnapradist S et al.. “Acute Kidney Allograft Rejection Precipitated by Lenalidomide Treatment for Multiple Myeloma.” American journal of kidney diseases : the official journal of the National Kidney Foundation (2017). PMID: 28189378 ↗

    L4CASE_REPORTCited in: Long-term and Definitive Management, Renal Replacement Therapy, Dialysis Access & Transplantation, Complications (Chronic Systemic Sequelae), Special Populations & Pregnancy
  73. [73]

    Heeger PS. “A complementary approach to treating antibody-mediated transplant rejection.” Kidney international (2010). PMID: 20588285 ↗

    L5OTHERCited in: Long-term and Definitive Management, Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  74. [74]

    Mühlbacher J, Schörgenhofer C, Doberer K et al.. “Anti-interleukin-6 antibody clazakizumab in late antibody-mediated kidney transplant rejection: effect on cytochrome P450 drug metabolism.” Transplant international : official journal of the European Society for Organ Transplantation (2021). PMID: 34153143 ↗

    L1RCTCited in: Long-term and Definitive Management, History and Evolution of Treatment
  75. [75]

    Murakami H, Nakamura Y, Miki K et al.. “Renal Transplantation in Relation to Positive T-cell Flow Cytometric Crossmatch: A Retrospective Study.” Transplantation proceedings (2025). PMID: 40581563 ↗

    L2COHORTCited in: Long-term and Definitive Management, Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  76. [76]

    Yi DZ, Jiao Y, Xiu CF et al.. “A pharmacovigilance study of sirolimus-associated adverse events in organ transplantation.” Frontiers in immunology (2026). PMID: 42317370 ↗

    L4OTHERCited in: Long-term and Definitive Management
  77. [77]

    Rossi M, Tartaglia E, Askarinejad A et al.. “Direct oral anticoagulants versus Vitamin K antagonist in kidney transplant recipients with atrial fibrillation: A study from a global federated research network.” European journal of internal medicine (2026). PMID: 41656124 ↗

    L2OTHERCited in: Long-term and Definitive Management, Renal Replacement Therapy, Dialysis Access & Transplantation
  78. [78]

    Wellekens K, Koshy P, Roufosse C et al.. “From Banff 1991 to Today: The Changing Landscape of the v-Lesion in Kidney Transplant Rejection.” Transplant international : official journal of the European Society for Organ Transplantation (2025). PMID: 40661921 ↗

    L5REVIEW_NARRATIVECited in: Long-term and Definitive Management, Complications (Chronic Systemic Sequelae)
  79. [79]

    van Vugt LK, Zwart TC, Bezstarosti S et al.. “Alemtuzumab Exposure and T Lymphocyte Depletion: A Population Pharmacokinetic-Pharmacodynamic Model of Alemtuzumab Induction Therapy for Kidney Transplantation.” Clinical pharmacology and therapeutics (2025). PMID: 40374867 ↗

    L2OTHERCited in: Long-term and Definitive Management
  80. [80]

    Rampersad C, Shaw J, Gibson IW et al.. “Early Antibody-Mediated Kidney Transplant Rejection Associated With Anti-Vimentin Antibodies: A Case Report.” American journal of kidney diseases : the official journal of the National Kidney Foundation (2019). PMID: 31515140 ↗

    L4CASE_REPORTCited in: Renal Replacement Therapy, Dialysis Access & Transplantation, History and Evolution of Treatment, Complications (Chronic Systemic Sequelae), Prognosis and Natural History, Special Populations & Pregnancy
  81. [81]

    Goebel JW. “Protein kinase Czeta: not-so-innocent bystander or unusual suspect in kidney transplant rejection?” Kidney international (2009). PMID: 19946312 ↗

    L5REVIEW_NARRATIVECited in: Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  82. [82]

    Sánchez-Zapardiel E, Mancebo E, Díaz-Ordoñez M et al.. “Isolated De Novo Antiendothelial Cell Antibodies and Kidney Transplant Rejection.” American journal of kidney diseases : the official journal of the National Kidney Foundation (2016). PMID: 27599627 ↗

    L2OTHERCited in: Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  83. [83]

    Vaulet T, Callemeyn J, Lamarthée B et al.. “The Clinical Relevance of the Infiltrating Immune Cell Composition in Kidney Transplant Rejection.” Journal of the American Society of Nephrology : JASN (2024). PMID: 38640017 ↗

    L2OTHERCited in: Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  84. [84]

    Zou Y, Stastny P, Süsal C et al.. “Antibodies against MICA antigens and kidney-transplant rejection.” The New England journal of medicine (2007). PMID: 17898098 ↗

    L2OTHERCited in: Renal Replacement Therapy, Dialysis Access & Transplantation, Prognosis and Natural History, Special Populations & Pregnancy
  85. [85]

    Mathern DR, Heeger PS. “Molecules Great and Small: The Complement System.” Clinical journal of the American Society of Nephrology : CJASN (2015). PMID: 25568220 ↗

    L5REVIEW_NARRATIVECited in: Renal Replacement Therapy, Dialysis Access & Transplantation, Complications (Chronic Systemic Sequelae), Prognosis and Natural History, Special Populations & Pregnancy
  86. [86]

    Caliskan Y, Karahan G, Akgul SU et al.. “LIMS1 risk genotype and T cell-mediated rejection in kidney transplant recipients.” Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (2021). PMID: 33909908 ↗

    L2OTHERCited in: Renal Replacement Therapy, Dialysis Access & Transplantation, Prognosis and Natural History, Special Populations & Pregnancy
  87. [87]

    Lo DJ, Kaplan B, Kirk AD. “Biomarkers for kidney transplant rejection.” Nature reviews. Nephrology (2014). PMID: 24445740 ↗

    L5REVIEW_NARRATIVECited in: Renal Replacement Therapy, Dialysis Access & Transplantation, Prognosis and Natural History, Special Populations & Pregnancy
  88. [88]

    Van Loon E, Lamarthée B, Callemeyn J et al.. “Active immunologic participation and metabolic shutdown of kidney structural cells during kidney transplant rejection.” American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2024). PMID: 39461479 ↗

    L4OTHERCited in: Renal Replacement Therapy, Dialysis Access & Transplantation, Prognosis and Natural History, Special Populations & Pregnancy
  89. [89]

    Mohammed MT, Cai S, Hanson BL et al.. “Follicular T cells mediate donor-specific antibody and rejection after solid organ transplantation.” American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2021). PMID: 33421294 ↗

    L5OTHERCited in: Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  90. [90]

    Olson A, Li YE, Basar R et al.. “Role of BK Virus CTLs in the Treatment of BK Virus-Associated Nephropathy in Kidney-Transplant and Hematopoietic Cell Transplant Recipients.” Transplant infectious disease : an official journal of the Transplantation Society (2026). PMID: 41645606 ↗

    L4TRIAL_NONRANDOMCited in: Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  91. [91]

    Casale R, Dello Strologo A, Alfieri C et al.. “Immunometabolic transcriptomic signatures of diabetes-related genes predict kidney transplant rejection.” Renal failure (2026). PMID: 41664343 ↗

    L3OTHERCited in: Renal Replacement Therapy, Dialysis Access & Transplantation, Special Populations & Pregnancy
  92. [92]

    Varin A, Palvair J, Messager L et al.. “A Subset of Pro-inflammatory CXCL10+ LILRB2+ Macrophages Derives From Recipient Monocytes and Drives Renal Allograft Rejection.” Advanced science (Weinheim, Baden-Wurttemberg, Germany) (2026). PMID: 41517835 ↗

    L4OTHERCited in: Renal Replacement Therapy, Dialysis Access & Transplantation
  93. [93]

    Lazarovits AI, Rochon J, Banks L et al.. “Human mouse chimeric CD7 monoclonal antibody (SDZCHH380) for the prophylaxis of kidney transplant rejection.” Journal of immunology (Baltimore, Md. : 1950) (1993). PMID: 7684422 ↗

    L1RCTCited in: History and Evolution of Treatment
  94. [94]

    Vigeral P, Chkoff N, Chatenoud L et al.. “Prophylactic use of OKT3 monoclonal antibody in cadaver kidney recipients. Utilization of OKT3 as the sole immunosuppressive agent.” Transplantation (1986). PMID: 3520988 ↗

    L1RCTCited in: History and Evolution of Treatment
  95. [95]

    Schroeder TJ, Moore LW, Gaber LW et al.. “The US multicenter double-blind, randomized, phase III trial of thymoglobulin versus atgam in the treatment of acute graft rejection episodes following renal transplantation: rationale for study design.” Transplantation proceedings (1999). PMID: 10330958 ↗

    L5RCTCited in: History and Evolution of Treatment
  96. [96]

    Flechner SM, Kurian SM, Head SR et al.. “Kidney transplant rejection and tissue injury by gene profiling of biopsies and peripheral blood lymphocytes.” American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2004). PMID: 15307835 ↗

    L3OTHERCited in: History and Evolution of Treatment
  97. [97]

    Halloran PF, Urmson J, Ramassar V et al.. “Lesions of T-cell-mediated kidney allograft rejection in mice do not require perforin or granzymes A and B.” American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons (2004). PMID: 15084164 ↗

    L5OTHERCited in: History and Evolution of Treatment
  98. [98]

    Eslami Kojidi M, Shatizadeh Malekshahi S, Jabbari MR. “The simultaneous presence of active BK, Epstein Barr, and human cytomegalovirus infection and their correlation by host factors in patients suspected of kidney transplant rejection.” BMC infectious diseases (2024). PMID: 39251898 ↗

    L4OTHERCited in: Complications (Chronic Systemic Sequelae)
  99. [99]

    Fichtner A, Schmidt J, Süsal C et al.. “Risk of cellular or antibody-mediated rejection in pediatric kidney transplant recipients with BK polyomavirus replication-an international CERTAIN registry study.” Pediatric nephrology (Berlin, Germany) (2024). PMID: 39392493 ↗

    L2OTHERCited in: Complications (Chronic Systemic Sequelae)
  100. [100]

    Perrin S, Magill M. “The Inhibition of CD40/CD154 Costimulatory Signaling in the Prevention of Renal Transplant Rejection in Nonhuman Primates: A Systematic Review and Meta Analysis.” Frontiers in immunology (2022). PMID: 35464470 ↗

    L5SR_OBSCited in: Prognosis and Natural History
  101. [101]

    Dandonneau J, François A, Bertrand D et al.. “Systematic Biopsy-Based Transcriptomics and Diagnosis of Antibody-Mediated Kidney Transplant Rejection in Clinical Practice.” Clinical journal of the American Society of Nephrology : CJASN (2024). PMID: 39012712 ↗

    L5OTHERCited in: Prognosis and Natural History
  102. [102]

    van Besouw NM, Yan L, de Kuiper R et al.. “The Number of Donor-Specific IL-21 Producing Cells Before and After Transplantation Predicts Kidney Graft Rejection.” Frontiers in immunology (2019). PMID: 31024571 ↗

    L2TRIAL_NONRANDOMCited in: Prognosis and Natural History
  103. [103]

    Marakala V. “Neutrophil gelatinase-associated lipocalin (NGAL) in kidney injury - A systematic review.” Clinica chimica acta; international journal of clinical chemistry (2022). PMID: 36150522 ↗

    L1SR_OBSCited in: Prevention, Screening & Surveillance
  104. [104]

    Lai X, Zheng X, Mathew JM et al.. “Tackling Chronic Kidney Transplant Rejection: Challenges and Promises.” Frontiers in immunology (2021). PMID: 34093552 ↗

    L5REVIEW_NARRATIVECited in: Prevention, Screening & Surveillance
  105. [105]

    Sharaby I, Alksas A, Abou El-Ghar M et al.. “Biomarkers for Kidney-Transplant Rejection: A Short Review Study.” Biomedicines (2023). PMID: 37760879 ↗

    L5REVIEW_NARRATIVECited in: Prevention, Screening & Surveillance
  106. [106]

    Punukollu R, Parajuli S, Chaudhari H et al.. “Genomic and Biomarker Innovations in Predicting Kidney Transplant Rejection.” Journal of clinical medicine (2025). PMID: 40507402 ↗

    L5REVIEW_NARRATIVECited in: Prevention, Screening & Surveillance
  107. [107]

    Grothgar E, Goerlich N, Samans B et al.. “Urinary CD8+HLA-DR+ T Cell Abundance Non-invasively Predicts Kidney Transplant Rejection.” Frontiers in medicine (2022). PMID: 35911418 ↗

    L2OTHERCited in: Prevention, Screening & Surveillance
  108. [108]

    Sellarés J, Casanova F, Perez-Saez MJ et al.. “Blood Gene Expression Profiling and Donor-derived Cell-free DNA to Noninvasively Diagnose Clinical and Subclinical Kidney Transplant Rejection: A Real-life Appraisal Study.” Transplantation (2024). PMID: 40020163 ↗

    L2OTHERCited in: Prevention, Screening & Surveillance
  109. [109]

    Banas MC, Neumann S, Pagel P et al.. “A urinary metabolite constellation to detect acute rejection in kidney allografts.” EBioMedicine (2019). PMID: 31648995 ↗

    L2OTHERCited in: Prevention, Screening & Surveillance

Revision History

All updates applied to this page

Loading revisions…