Chronic Active AMR — ESENeph MCQ
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Correct answer: D — Chronic active antibody-mediated rejection
The best answer is “Chronic active antibody-mediated rejection”. Banff recognizes C4d-negative antibody-mediated rejection when chronic tissue injury, current microvascular activity and evidence of antibody interaction are otherwise established. “Acute T-cell-mediated rejection” is less appropriate because transplant glomerulopathy and donor-specific antibody support chronic antibody injury “BK nephropathy” is less appropriate because viral cytopathic or molecular evidence is absent “Calcineurin-inhibitor toxicity” is less appropriate because this does not explain DSA-associated microvascular inflammation “Recurrent IgA nephropathy” is less appropriate because mesangial IgA deposits rather than transplant glomerulopathy would define recurrence
Reference: KDIGO guideline for care of kidney-transplant recipients: https://kdigo.org/wp-content/uploads/2017/02/KDIGO-2009-Transplant-Recipient-Guideline-English.pdf