Acute rejection, kidney, H/E x 100
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This kidney was removed 4 months after transplant, when all immunosuppressive therapy failed to stop the rejection process. Histologically, there is a marked proliferation of the intima, and the lumen of the vessel has virtually disappeared. Fibrinoid necrosis occurred in some sections, but is not prominent here. As you can imagine, this degree of compromise of the vessel can lead to renal infarcts, with subsequent scarring. Other areas of the kidney simply showed mild fibrosis and tubular atrophy, depending on the status of the vessels.