Treatment of Acute T-Cell Mediated Rejection

Treatment depends on classification on histology and the clinical status of patient.

Acute T-Cell Medicated Rejection (Acute Cellular rejection)

1. Type IA or IB acute cellular rejection (no evidence of vascular or antibody-mediated rejection)

  • Methylprednisolone 500mg IV daily for 3 doses
  • Consider ATG if steroid resistant cellular rejection

2. Type IIA, IIB or vascular rejection

  • Methylprednisolone 500mg IV daily for 3 doses
  • ATG treatment dosing

See further information on ATG dosing here.

If a follow up biopsy is being considered after treatment for AR, it’s timing should be considered. There will be lag between treatment and improvement of lesions on the biopsy, especially if the initial biopsy was very inflamed.