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Expression of activation markers, HLA class II and IL‐2R in acute vascular rejection of human renal allografts

We analyzed the expression of class II antigens on graft tubular cells and the expression of IL‐2R on lymphoid cells in 314 prospective aspiration biopsies taken from 30 consecutive patients with histologically verified acute vascular rejection (AVR). Based on histology, two main groups were seen: 11 grafts had features of AVR only and 19 grafts had a combination of AVR and acute cellular rejection (ACR). The AVR findings were also predominant in the latter group. In the grafts with a combination of AVR and ACR, patterns similar to ordinary ACR were seen in class II and IL‐2R expression. On the contrary, no class II or IL‐2R induction could be seen in the grafts with pure AVR and irreversible rejection. This pattern, demonstrated by immunocytology, suggested that AVR is a heterogenous group of rejections, where different cellular and molecular mechanisms are operating. Humoral mechanisms might be involved in these rejections.