Kidney Week 2025 Early Program - Care of Kidney Transplant Candidates and Recipients-Identifying and Treating Kidney Transplant Rejection

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Video Summary

Dr. Rosalyn Manon reviews how modern immunosuppression has greatly reduced first-year kidney transplant rejection rates, yet long-term graft survival has improved only modestly. Rejection still carries major financial and medical costs. She emphasizes evaluating rising creatinine with a full AKI differential (pre/post-renal issues, ultrasound, urine studies, drug levels), noting current blood biomarkers lack diagnostic specificity; biopsy remains essential. Using Banff criteria, cellular rejection is defined by tubulitis/arteritis, typically treated with steroid pulses and sometimes ATG plus increased maintenance therapy. Antibody-mediated rejection requires histologic injury plus endothelial antibody interaction and donor-specific antibodies; late/de novo DSA AMR is hardest to treat. Follow-up biopsy may be needed to assess response and prognosis.

Asset Subtitle

Roslyn Mannon

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Module TRX

Speaker Roslyn Mannon

Keywords

kidney transplant rejection

Banff criteria

acute cellular rejection treatment

antibody-mediated rejection (AMR) and donor-specific antibodies

rising creatinine evaluation and transplant biopsy