Kidney Transplant T-Cell Rejection🔥 🔬 | Nephrology Board Review

🩺 How does biopsy severity guide treatment of T-cell–mediated rejection (TCMR)? 🔹 Banff IA/IB — Tubulitis without arteritis: High-dose IV corticosteroids, typically methylprednisolone for 3 days, are commonly first-line. 🔹 Banff IIA — Mild intimal arteritis: IV corticosteroids; consider antithymocyte globulin (ATG) based on severity and clinical response. 🔹 Banff IIB — Severe intimal arteritis: More aggressive treatment; ATG is often considered alongside IV corticosteroids. 🔹 Banff III — Transmural arteritis or arterial fibrinoid necrosis: Severe vascular rejection; typically requires intensive treatment, often including ATG. 🎯 Board Review Pearl: Tubulitis-predominant TCMR is commonly treated with steroids. Arteritis, especially Banff IIB–III, signals more severe rejection and may warrant T-cell–depleting therapy. Treatment should be individualized based on biopsy findings, graft function, infection risk, and response to therapy. ⚠️ For educational purposes only; not individual medical advice. #NephroHighYield #Nephrology #KidneyTransplant #TCMR #BanffClassification #TransplantRejection #NephrologyBoards #MedicalEducation