A 46-year-old man undergoes kidney transplantation. Two weeks post-operatively, he develops hypertension (BP 158/92 mmHg), tachycardia (HR 104/min), and malaise. Serum creatinine rises to 3.2 mg/dL from baseline 1.0 mg/dL. Renal biopsy demonstrates dense interstitial lymphocytic infiltrates with tubulitis. Donor-specific antibodies are not detected on screening. He denies fever and urinalysis shows no proteinuria. Which mechanism best explains these histopathologic findings?
- A)Recipient T lymphocytes attack donor major histocompatibility antigens in the graftGABARITO
- B)Immune complexes deposit in the renal interstitium after foreign protein exposure
- C)Donor T lymphocytes attack recipient skin, gut, and liver
- D)Progressive intimal smooth muscle proliferation due to chronic antibody mediated injury
- E)Preformed recipient antibodies bind graft endothelium and activate complement immediately
Explicação
Acute cellular rejection is driven by recipient T cells that recognize donor HLA antigens and attack the graft. The timing after transplant and the biopsy finding of interstitial lymphocytes with tubulitis are classic for this process. Ver explicação completa e trilha adaptativa →