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acute humoral rejection

Tuesday 10 March 2009

Acute humoral rejection (rejection vasculitis) is mediated primarily by antidonor antibodies, and hence it is manifested mainly by damage to the blood vessels.

This may take the form of necrotizing vasculitis with endothelial cell necrosis, neutrophilic infiltration, deposition of immunoglobulins, complement, and fibrin, and thrombosis.

Such lesions are associated with extensive necrosis of the renal parenchyma. In many cases, the vasculitis is less acute and is characterized by marked thickening of the intima by proliferating fibroblasts, myocytes, and foamy macrophages.

The resultant narrowing of the arterioles may cause infarction or renal cortical atrophy. The proliferative vascular lesions mimic arteriosclerotic thickening and are believed to be caused by cytokines that cause growth of vascular smooth muscles.

See also

- acute rejection