Kidney transplantation: mechanisms of rejection and acceptance

Annu Rev Pathol. 2008;3:189-220. doi: 10.1146/annurev.pathmechdis.3.121806.151508.


We describe the molecular and cellular mechanisms believed to be responsible for the rejection of renal allografts, including acute T cell-mediated rejection, acute antibody-mediated (humoral) rejection, rejection mediated by the innate immune system, and chronic rejection. We present mechanisms of graft acceptance, including accommodation, regulation, and tolerance. Studies in animals have replicated many pathologic features of acute and chronic rejection. We illuminate the pathogenesis of human pathology by reflection from experimental models.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Acute Disease
  • Animals
  • Chronic Disease
  • Disease Models, Animal
  • Graft Rejection / immunology*
  • Graft Survival / immunology*
  • Humans
  • Kidney Transplantation / immunology*
  • Mice
  • Mice, Inbred Strains
  • Transplantation Tolerance / immunology*
  • Transplantation, Homologous