Renal allograft rejection represents the combined efforts of cellular and humoral immunity. The tissue targets are the renal allograft vasculature, and to a lesser extent, the glomeruli. The temporal sequence and predominant pathophysiological features of rejection are clearly related to histocompatibility differences between the donor organ and recipient. A better understanding of these pathophysiological processes has given some insight into its immunological sequelae of rejection. However, despite the rapidly expanding knowledge about renal allograft rejection, many basic tenets and a specific therapeutic approach remain to be eludicated.
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