Evidence for the alloimmune basis and prognostic significance of Borderline T cell–mediated rejection

Abstract

Prognostic biomarkers of T cell–mediated rejection (TCMR) have not been adequately studied in the modern era. We evaluated 803 renal transplant recipients and correlated HLA-DR/DQ molecular mismatch alloimmune risk categories (low, intermediate, high) with the severity, frequency, and persistence of TCMR. Allograft survival was reduced in recipients with Banff Borderline (hazard ratio [HR] 2.4, P =.003) and Banff ≥ IA TCMR (HR 4.3, P