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Citation:
Weerakkody Y, Sharma R, Luong D, et al. Chronic renal transplant rejection. Reference article, Radiopaedia.org (Accessed on 14 May 2024) https://doi.org/10.53347/rID-41927
Chronic renal transplant rejection is a form of renal transplant rejection.
Chronic rejection is defined as a gradual deterioration in graft function beginning at least 3 months after transplantation 3.
The creatinine levels may rise but this does not allow differentiation from acute transplant rejection.
Histological diagnosis is made by demonstration of graft arteries and arteriolar proliferation, interstitial cellular infiltration and fibrosis, tubular atrophy, and glomerular changes.
Risk factors
- previous episodes of acute rejection
Ultrasound
Imaging of choice. Features include:
- mild dilatation of the collecting system: may occasionally be seen in cases of chronic rejection
- the cortex may be thin
- narrowing at the ureterovesical junction
- focal pyelonephritis
- elevated renal arterial resistive indices
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