A 28-year-old receives a renal transplant. Biopsy on day 3 shows neutrophilic infiltration of vessel walls with fibrinoid necrosis, and pre-formed donor-specific HLA antibodies are detected. What type of rejection is this?
- A Hyperacute rejection
- B Accelerated acute rejection ✓
- C Acute cellular rejection
- D Chronic allograft nephropathy
Correct answer: B. Accelerated acute rejection
Explanation
Accelerated acute rejection (days 2–5) is mediated by pre-formed low-titer antibodies or sensitized memory T cells and differs from hyperacute rejection (minutes to hours intraoperatively) only in timing and titer; the biopsy showing vasculitis on day 3 with pre-formed antibodies fits accelerated acute, not true hyperacute. Acute cellular rejection peaks at weeks 1–3 and shows lymphocytic tubulitis; chronic rejection develops over months to years with intimal fibrosis.
Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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