CCTC KIDNEY TRANSPLANT 2026
SURGICAL PROCEDURE OVERVIEW
PERIOPERATIVE CARE AND PATIENT
MANAGEMENT NOTES
◉ Biopsy findings indicative of a Type IIB Banff Classification would
include...
Answer: Severe arteritis with or without interstitial inflammation
and/or tubulitis
◉ Biopsy findings indicative of a Type III Banff Classification would
include...
Answer: Transmural arteritis and/or arterial fibrinoid necrosis of
smooth muscle
◉ Diagnostic categories of the Banff 2017 Classification system
provide...
Answer: Histologic evidence of acute tissue injury
Serologic evidence of DSA or C4d positivity in the presence of MVI
Evidence of current/recent antibody interaction with vascular
endothelium, including at least one of the following:Positive C4D
stainingModerate microvascular inflammation (MVI)Increased
expression of validated gene transcripts/classifiers
, ◉ Biopsy findings for Chronic Active ABMR will present with...
Answer: Morphologic evidence of chronic tissue injury
Antibody endothelium interaction
DSA or MVI + C4d
◉ Treatment for Acute Rejection may include...
Answer: Mild cellular rejection: Corticosteroid bolus followed by
oral prednisone taper
Severe cellular or vascular rejection treated with Thymoglobulin
Antibody-mediated rejection - Rituximab, IVIG, Plasmapheresis:
Monitor for side effects - pulmonary edema, fevers, chills, malaise
◉ Long term consequence of Acute Rejection may include...
Answer: Permanent scar/fibrosis of kidney cells which do not
recover
Factors which determine outcome after rejection:
Previous insults to kidney
Host factors
Severity of rejection episodes
Patient adherence
SURGICAL PROCEDURE OVERVIEW
PERIOPERATIVE CARE AND PATIENT
MANAGEMENT NOTES
◉ Biopsy findings indicative of a Type IIB Banff Classification would
include...
Answer: Severe arteritis with or without interstitial inflammation
and/or tubulitis
◉ Biopsy findings indicative of a Type III Banff Classification would
include...
Answer: Transmural arteritis and/or arterial fibrinoid necrosis of
smooth muscle
◉ Diagnostic categories of the Banff 2017 Classification system
provide...
Answer: Histologic evidence of acute tissue injury
Serologic evidence of DSA or C4d positivity in the presence of MVI
Evidence of current/recent antibody interaction with vascular
endothelium, including at least one of the following:Positive C4D
stainingModerate microvascular inflammation (MVI)Increased
expression of validated gene transcripts/classifiers
, ◉ Biopsy findings for Chronic Active ABMR will present with...
Answer: Morphologic evidence of chronic tissue injury
Antibody endothelium interaction
DSA or MVI + C4d
◉ Treatment for Acute Rejection may include...
Answer: Mild cellular rejection: Corticosteroid bolus followed by
oral prednisone taper
Severe cellular or vascular rejection treated with Thymoglobulin
Antibody-mediated rejection - Rituximab, IVIG, Plasmapheresis:
Monitor for side effects - pulmonary edema, fevers, chills, malaise
◉ Long term consequence of Acute Rejection may include...
Answer: Permanent scar/fibrosis of kidney cells which do not
recover
Factors which determine outcome after rejection:
Previous insults to kidney
Host factors
Severity of rejection episodes
Patient adherence
