Acute Cellular Rejection

Madhav C. Menon, Paolo Cravedi, Fadi El Salem

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


Acute cellular rejection (ACR) is the consequence of an immune response of the host against the kidney graft. It is clinically suspected in patients experiencing an increase in serum creatinine, after the exclusion of other causes of graft dysfunction (generally with biopsy). Histological analysis of graft biopsy is the gold standard technique to diagnose ACR. However, graft biopsy can recognize the immune reaction only at its later stages, when allograft injury has already been established. Therefore, identification of noninvasive biomarkers capable of identifying early signs of acute rejection represents an area of intense research. ACR is often treatable, but it still represents an adverse risk factor affecting long-term graft survival. The occurrence of ACR episodes in modern transplantation should always elicit a search for underimmunosuppression relative to what is understood as a given recipient's risk for ACR. Importantly, patient adherence to therapy should be carefully addressed.

Original languageEnglish
Title of host publicationKidney Transplantation, Bioengineering, and Regeneration
Subtitle of host publicationKidney Transplantation in the Regenerative Medicine Era
PublisherElsevier Inc.
Number of pages14
ISBN (Electronic)9780128018361
ISBN (Print)9780128017340
StatePublished - 6 Jul 2017


  • Acute cellular rejection
  • Biomarker
  • Molecular diagnosis
  • Subclinical rejection
  • T cells


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