A 52-yrs-old woman in renal failure is listed as a transplant candidate. In order to assess the propriety of the transplant, a cross-match is performed by incubating:
|A||Donor serum with recipient lymphocytes and complement|
|B||Donor lymphocytes with recipient serum and complement|
|C||Donor lymphocytes with recipient lymphocytes|
|D||Recipient serum with a known panel of multiple donor lymphocytes|
a. Hyperacute rejection occurs immediately after renal revascularization.
c. It is very rare when the microlymphocytotoxicity crossmatch between recipient serum and donor lymphocytes is negative.
d. Accelerated rejection is mediated by humoral and cellular components of the immune response.
e. It occurs within days to weeks and often does not respond to antirejection therapy.
f. Acute rejection can occur any time after transplantation.
g. The symptoms of acute kidney transplant rejection are those of “the flu,” accompanied by pain over an enlarged kidney graft, hypertension, decreased urinary output, fluid retention, increased serum creatinine levels, and radioisotope renography indicating decreased renal blood flow, glomerular filtration, and tubular function.
h. Needle biopsy of the kidney graft is the standard to confirm the diagnosis of acute rejection.
i. The typical histologic findings of acute renal allograft rejection are mononuclear cellular infiltration, tubulitis, and vasculitis..
j. The Banff classification is now accepted as the standard schema for diagnosing rejection .
k. Chronic rejection is characterized by a gradual decline in renal function associated with interstitial fibrosis, vascular changes, and minimal mononuclear cell infiltration.