Transplant Question 24

A 32-year-old woman with a history of blood transfusions and one pregnancy underwent a living-donor renal transplant three weeks prior to presentation. Creatinine on discharge was 98 µmol/L. Her next blood test three days later shows a creatinine of 240 µmol/L. You suspect she has antibody-mediated rejection.

What are the findings on renal biopsy that suggest acute humoral rejection? How would you treat her?