Monocyte infiltration and kidney allograft dysfunction during acute rejection

R. Girlanda, D. E. Kleiner, Z. Duan, E. A.S. Ford, E. C. Wright, R. B. Mannon, A. D. Kirk*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

106 Scopus citations


Multiple cell types infiltrate acutely rejecting renal allografts. Typically, monocytes and T cells predominate. Although T cells are known to be required for acute rejection, the degree to which monocytes influence this process remains incompletely defined. Specifically, it has not been established to what degree monocytes impact the clinical phenotype of rejection or how their influence compares to that of T cells. We therefore investigated the relative impact of T cells and monocytes by correlating their presence as measured by immunohistochemical staining with the magnitude of the acute change in renal function at the time of biopsy in 78 consecutive patients with histological acute rejection. We found that functional impairment was strongly associated with the degree of overall cellular infiltration as scored using Banff criteria. However, when cell types were considered, monocyte infiltration was quantitatively associated with renal dysfunction while T-cell infiltration was not. Similarly, renal tubular stress, as indicated by HLA-DR expression, increased with monocyte but not T-cell infiltration. These data suggest that acute allograft dysfunction is most closely related to monocyte infiltration and that isolated T-cell infiltration has less acute functional impact. This relationship may be useful in assigning acute clinical relevance to biopsy findings.

Original languageEnglish
Pages (from-to)600-607
Number of pages8
JournalAmerican Journal of Transplantation
Issue number3
StatePublished - Mar 2008
Externally publishedYes


  • Acute rejection
  • Histopathology
  • Kidney transplantation
  • Monocytes
  • T cells


Dive into the research topics of 'Monocyte infiltration and kidney allograft dysfunction during acute rejection'. Together they form a unique fingerprint.

Cite this