Various types of kidney transplant rejection as defined by time

What are the various types of kidney transplant rejection as defined by time?

There are three general types of organ rejection:

  • 1. Hyperacute
  • 2. Acute
  • 3. Chronic

Hyperacute rejection is a complement-mediated response by the recipient with preexisting donor specific antibodies (DSA). Hyperacute rejection occurs almost immediately following organ implantation and necessitates immediate explant of the organ. Hyperacute rejection is uncommon with pre-transplantation cross-matches and screening.

Acute rejection is associated with a sudden deterioration in allograft function that can occur as early as 1 week post-transplantation. Acute rejection may also be subclinical, associated with a more insidious rise in creatinine. Acute rejection has a major adverse effect on long-term graft survival.

Chronic rejection, better defined as chronic antibody-mediated rejection (AMR), is the main cause of late allograft loss and is histologically defined as transplant glomerulopathy (TG).


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