This volume in the Diagnostic Pathology series is an ideal point-of-care resource for practitioners at all levels of experience and training. Covering the full range of solid organ transplantation (SOT) of the kidney, liver, heart, lung, pancreas, intestine, and more, it provides a current understanding of transplant immunology and pathology to help ensure accurate diagnosis for optimal clinical management. Richly illustrated and easy to use, Diagnostic Pathology: Transplant Pathology, third edition, is a visually stunning, one-stop reference for practicing pathologists, transplant practitioners, and students of organ transplantation.

SECTION 1: IMMUNOLOGY

4 Immune Response in Organ Transplantation
Roshini Sarah Abraham, PhD, D(ABMLI)

8 Regulatory Immune Cells and Transplant Tolerance
Roshini Sarah Abraham, PhD, D(ABMLI)

14 Viral Infections and Immune Response
Roshini Sarah Abraham, PhD, D(ABMLI)

20 Genetics of Complement Defects Associated with Atypical HUS and TMA
Roshini Sarah Abraham, PhD, D(ABMLI)

24 Laboratory-Based Immune Monitoring in Organ Transplantation
Sanya J. Thomas, MD and Roshini Sarah Abraham, PhD, D(ABMLI)

30 Immune Manipulation and Accommodation: Introduction to Xenogenic Transplantation
Roshini Sarah Abraham, PhD, D(ABMLI)

34 Graft Vs. Host Disease in Solid Organ Transplantation
Roshini Sarah Abraham, PhD, D(ABMLI) and Sanya J. Thomas, MD

SECTION 2: HLA TESTING

40 Human Leukocyte Antigen System
Manish J. Gandhi, MD

42 Histocompatibility Testing
Manish J. Gandhi, MD

44 Transplantation and HLA
Manish J. Gandhi, MD

48 ABO Blood Group Antigens and Transplantation
Manish J. Gandhi, MD

50 Apheresis and Transplantation
Manish J. Gandhi, MD

52 HLA and Transfusion
Manish J. Gandhi, MD
SECTION 3: IMMUNOSUPPRESSIVE DRUGS

56 Mechanism of Action of Immunosuppressive Drugs
Loralie Langman, PhD and Florian Lemaitre, PharmaD, PhD

58 Therapeutic Drug Monitoring in Transplant Patients
Loralie Langman, PhD and Florian Lemaitre, PharmaD, PhD

62 History of Immunosuppression Drugs in Transplantation
Loralie Langman, PhD and Florian Lemaitre, PharmaD, PhD
SECTION 4: KIDNEY TRANSPLANTATION

66 History of Kidney Transplantation
Lynn D. Cornell, MD

68 Pathologic Classification of Renal Allograft Diseases
Robert B. Colvin, MD

70 Examination of End-Stage Kidney
Shane Meehan, MB, BCh

76 Evaluation of the End-Stage Kidney
Shane Meehan, MB, BCh

82 Evaluation of Allograft Kidney
Lynn D. Cornell, MD and Evan Farkash, MD, PhD

88 Evaluation of Donor Kidney
Lynn D. Cornell, MD and Evan Farkash, MD, PhD

94 Evaluation of Transplant Nephrectomy
Shane Meehan, MB, BCh and Evan Farkash, MD, PhD

98 Evaluation of Fibrosis
A. Brad Farris, III, MD, MBA

102 Protocol Biopsies
Lynn D. Cornell, MD and Evan Farkash, MD, PhD

106 Accommodation
Lynn D. Cornell, MD

108 Tolerance
Robert B. Colvin, MD
SURGICAL COMPLICATIONS

112 Acute Allograft Ischemia
A. Brad Farris, III, MD, MBA

116 Size Mismatch Allograft Injury
Anthony Chang, MD and Yael K. Heher, MD, MPH, FRCP(C)

118 Urine Leak
A. Brad Farris, III, MD, MBA

119 Lymphocele
A. Brad Farris, III, MD, MBA

120 Multinucleated Endotheliopathy
Jonathan Zuckerman, MD, PhD

124 Transplant Renal Artery Stenosis
A. Brad Farris, III, MD, MBA

126 Tranplant Renal Artery or Vein Thrombosis
A. Brad Farris, III, MD, MBA

128 Kidney Xenografts
Ivy A. Rosales, MD

132 Chronic Antibody-Mediated Rejection
Lynn D. Cornell, MD and Michael Mengel, MD
ALLOGRAF REJECTION

144 Hyperacute Rejection
Lynn D. Cornell, MD and Michael Mengel, MD

148 Acute T-Cell-Mediated Rejection
Lynn D. Cornell, MD and Michael Mengel, MD

158 Chronic T-Cell-Mediated Rejection
Lynn D. Cornell, MD and Michael Mengel, MD

162 Acute Antibody-Mediated Rejection
Lynn D. Cornell, MD and Michael Mengel, MD

170 Transcript Analysis of Renal Transplant Biopsies
Michael Mengel, MD and R. Neal Smith, MD, PhD
RECURRENT AND DE NOVO DISEASES

174 Diseases That Recur in Allografts
Anthony Chang, MD, Lynn D. Cornell, MD, and R. Neal Smith, MD, PhD

180 De Novo Focal Segmental Glomerulosclerosis
Anthony Chang, MD and Astrid Weins, MD, PhD

182 De Novo Membranous Nephropathy
Anthony Chang, MD

186 Anti-GBM Disease in Alport Syndrome
Anthony Chang, MD and R. Neal Smith, MD, PhD

188 Chimerism Transition Syndrome
A. Brad Farris, III, MD, MBA

190 Late Posttransplant Histology
Lynn D. Cornell, MD
KIDNEY PATHOLOGY OF RECIPIENTS OF OTHER TRANSPLANTS

192 Kidney Diseases in Nonrenal Transplant Recipients
Robert B. Colvin, MD

196 Graft-vs.-Host Glomerulopathies
Anthony Chang, MD and Yael K. Heher, MD, MPH, FRCP(C)

DRUG TOXICITIES

198 Calcineurin Inhibitor Toxicity
Shane Meehan, MB, BCh

204 mTOR Inhibitor Toxicity
Lynn D. Cornell, MD
INFECTIONS

206 Acute Pyelonephritis
Neeraja Kambham, MD

214 Polyomavirus Nephritis
Anthony Chang, MD and Evan Farkash, MD, PhD

222 Adenovirus Infection
Anthony Chang, MD and R. Neal Smith, MD, PhD

224 Cytomegalovirus Infection
Anthony Chang, MD and R. Neal Smith, MD, PhD

226 Mucormycosis
Anthony Chang, MD

228 Histoplasmosis
Anthony Chang, MD

229 Candidiasis
Anthony Chang, MD

230 Cryptococcosis
Anthony Chang, MD

231 Aspergillosis
Anthony Chang, MD

232 Coccidioidomycosis
Anthony Chang, MD

233 Paracoccidioidomycosis
Anthony Chang, MD

234 Microsporidiosis
Robert B. Colvin, MD

236 Tuberculosis
Neeraja Kambham, MD

238 Malakoplakia
Neeraja Kambham, MD

242 Nocardiosis
Neeraja Kambham, MD
SECTION 5: LIVER TRANSPLANTATION

246 Pathologic Classification of Liver Allograft Diseases
John Hart, MD and Lindsay Alpert, MD

248 Gross Evaluation of Failed Native Liver
John Hart, MD and Lindsay Alpert, MD

252 Evaluation of Failed Liver Allograft
John Hart, MD and Lindsay Alpert, MD

254 Evaluation of the Donor Liver
John Hart, MD

258 History of Liver Transplantation
Anthony Chang, MD and John Hart, MD
POSTTRANSPLANT SURGICAL COMPLICATIONS

260 Preservation Injury
Hanlin L. Wang, MD, PhD

262 Hepatic Artery Thrombosis
Lisa Yerian, MD

264 Portal Vein Thrombosis
Lisa Yerian, MD

266 Bile Duct Stricture, Leak, Sludge, Biloma
Hanlin L. Wang, MD, PhD

268 Hepatic Venous Outflow Obstruction
Hanlin L. Wang, MD, PhD

272 Hyperperfusion Syndrome
Hanlin L. Wang, MD, PhD
ALLOGRAFT REJECTION

274 T-Cell-Mediated Rejection, Liver
Lisa Yerian, MD

278 Antibody-Mediated Rejection, Liver
Hanlin L. Wang, MD, PhD, Robert B. Colvin, MD, and
Richard Masia, MD, PhD

282 Chronic (Ductopenic) Rejection
Matthew M. Yeh, MD, PhD
RECURRENT DISEASES IN LIVER ALLOGRAFT

284 Recurrent Hepatitis B Virus
Lindsay Alpert, MD

286 Recurrent Hepatitis C Virus
Lindsay Alpert, MD

290 Fibrosing Cholestatic HBV or HCV Hepatitis
Lindsay Alpert, MD

292 Recurrent Autoimmune Hepatitis
Lindsay Alpert, MD

294 Recurrent Primary Biliary Cholangitis
Lindsay Alpert, MD

296 Recurrent Primary Sclerosing Cholangitis
Lindsay Alpert, MD

298 Recurrent Fatty Liver Disease
Lindsay Alpert, MD
INFECTIONS

300 Cytomegalovirus
Maria Westerhoff, MD and Joseph Ahn, MD, MS, FACG

302 Herpes Simplex Virus
Maria Westerhoff, MD and Joseph Ahn, MD, MS, FACG

304 Adenovirus, Liver
Maria Westerhoff, MD and Joseph Ahn, MD, MS, FACG

306 Hepatitis E Virus
Maria Westerhoff, MD and Joseph Ahn, MD, MS, FACG

308 Epstein-Barr Virus, Liver
Maria Westerhoff, MD and Joseph Ahn, MD, MS, FACG

312 Fungal Infections, Liver
Maria Westerhoff, MD and Joseph Ahn, MD, MS, FACG
LATE-GRAFT DYSFUNCTION

314 Plasma Cell-Rich Rejection
Lisa Yerian, MD

316 Graft-vs.-Host Disease, Liver
Lisa Yerian, MD
SECTION 6: HEART TRANSPLANTATION

320 Pathologic Classification of Cardiac Allograft Diseases
Aliya N. Husain, MD

322 Evaluation of Failed Native and Transplanted Heart
Jennifer Pogoriler, MD, PhD

324 History of Heart Transplantation
Aliya N. Husain, MD and Aarti Sharma, MD
EVALUATION OF EXPLANTED HEART

326 Ischemic Heart Disease
Aliya N. Husain, MD and Aarti Sharma, MD

330 Dilated Cardiomyopathy
Jennifer Pogoriler, MD, PhD

334 Hypertrophic Cardiomyopathy
Jennifer Pogoriler, MD, PhD and Aliya N. Husain, MD

338 Congenital Heart Disease
Jennifer Pogoriler, MD, PhD and Aliya N. Husain, MD

342 Sarcoidosis, Heart
Aliya N. Husain, MD and Aarti Sharma, MD

344 Arrhythmogenic Right Ventricular Cardiomyopathy
Jennifer Pogoriler, MD, PhD and Aliya N. Husain, MD

348 Other Causes of End-Stage Heart Disease
Jennifer Pogoriler, MD, PhD and Aliya N. Husain, MD
ALLOGRAFT REJECTION

354 Acute Cellular Rejection, Heart
Aliya N. Husain, MD and Jennifer Pogoriler, MD, PhD

358 Antibody-Mediated Rejection, Heart
Aliya N. Husain, MD and Aarti Sharma, MD

360 Chronic Allograft Vasculopathy, Heart
Aliya N. Husain, MD and Aarti Sharma, MD
NONINFECTIOUS LESIONS

362 Quilty Lesions
Aliya N. Husain, MD and Aarti Sharma, MD

364 Site of Previous Biopsy
Aliya N. Husain, MD and Vijayalakshmi
Ananthanarayanan, MD
INFECTIONS

366 Myocarditis
Jennifer Pogoriler, MD, PhD and Aliya N. Husain, MD
SECTION 7: LUNG TRANSPLANTATION

374 Pathologic Classification of Lung Allograft Diseases
Aliya N. Husain, MD and Aarti Sharma, MD

376 Examination of Native and Transplanted Lungs
Aliya N. Husain, MD

378 History of Lung Transplantation
Aliya N. Husain, MD and Aarti Sharma, MD
EVALUATION OF FAILED NATIVE LUNG

380 Emphysema
Aliya N. Husain, MD

382 Cystic Fibrosis
Aliya N. Husain, MD

384 Idiopathic Pulmonary Fibrosis
Aliya N. Husain, MD and Aarti Sharma, MD

386 Connective Tissue Disease-Associated Lung Disease
Ilyssa O. Gordon, MD, PhD and Aliya N. Husain, MD

388 Sarcoidosis, Lung
Aliya N. Husain, MD

390 Pulmonary Arterial Hypertension
Aliya N. Husain, MD and Aarti Sharma, MD

392 Other Causes of End-Stage Lung Disease
Aliya N. Husain, MD and Aarti Sharma, MD
SURGICAL COMPLICATIONS

396 Surgical Aspects and Complications, Lung
Aliya N. Husain, MD and Aarti Sharma, MD
ALLOGRAFT REJECTION

398 Pathologic Classification of Rejection
Aliya N. Husain, MD and Aarti Sharma, MD

400 Antibody-Mediated Rejection, Lung
Aliya N. Husain, MD and Ilyssa O. Gordon, MD, PhD

402 Acute Cellular Rejection, Grade A
Aliya N. Husain, MD

404 Acute Cellular Rejection, Grade B
Aliya N. Husain, MD

406 Chronic Allograft Dysfunction, Lung
Aliya N. Husain, MD
NONINFECTIOUS LESIONS

408 Organizing Pneumonia
Aliya N. Husain, MD

410 Microaspiration
Aliya N. Husain, MD
INFECTIONS

412 Bacterial Infections
Aliya N. Husain, MD and Ilyssa O. Gordon, MD, PhD

414 Viral Infections
Aliya N. Husain, MD and Aarti Sharma, MD

418 Fungal Infections, Lung
Aliya N. Husain, MD
SECTION 8: INTESTINAL TRANSPLANTATION

424 Pathologic Classification of Intestinal Allograft Diseases
Sarangarajan Ranganathan, MD

426 Indications and Evaluation of Explant
Sarangarajan Ranganathan, MD

430 Reperfusion Injury
Sarangarajan Ranganathan, MD

434 History of Intestinal and Multivisceral Transplantation
Sarangarajan Ranganathan, MD
ALLOGRAFT REJECTION/IMMUNOLOGICAL INJURY

436 Acute Antibody-Mediated Rejection, Intestine
Sarangarajan Ranganathan, MD

440 Acute Cellular Rejection, Intestine
Sarangarajan Ranganathan, MD

448 Chronic Rejection, Intestine
Sarangarajan Ranganathan, MD

452 Stomach Rejection
Sarangarajan Ranganathan, MD

456 Colon Rejection
Sarangarajan Ranganathan, MD

460 Graft-vs.-Host Disease, Intestine
Sarangarajan Ranganathan, MD
INFECTIONS

464 Bacterial and Fungal Infections
Sarangarajan Ranganathan, MD

468 Adenovirus, Intestine
Sarangarajan Ranganathan, MD

472 Rotavirus, Cytomegalovirus, and Herpes Simplex Virus
Sarangarajan Ranganathan, MD

476 Epstein-Barr Virus, Intestine
Sarangarajan Ranganathan, MD
SECTION 9: PANCREAS TRANSPLANTATION

484 Pathologic Classification of Pancreas Allograft Diseases
Surya V. Seshan, MD and Billie S. Fyfe, MD

486 Clinical Considerations in Pancreas Transplant Evaluation
Surya V. Seshan, MD and Billie S. Fyfe, MD

492 History of Pancreas Transplantation
Surya V. Seshan, MD and Billie S. Fyfe, MD

494 History of Islet Transplantation
Piotr Witkowski, MD, PhD
SURGICAL COMPLICATIONS

498 Surgical Aspects and Complications, Pancreas
Surya V. Seshan, MD and Billie S. Fyfe, MD
ALLOGRAF REJECTION

504 Acute Cellular Rejection, Pancreas
Surya V. Seshan, MD, Billie S. Fyfe, MD, and Erika R. Bracamonte, MD

508 Antibody-Mediated Rejection, Pancreas
Surya V. Seshan, MD and Billie S. Fyfe, MD

512 Chronic Allograft Rejection/Graft Sclerosis
Surya V. Seshan, MD, Billie S. Fyfe, MD, and Erika R. Bracamonte, MD

GRAFT DYSFUNCTION

514 Recurrent Diabetes Mellitus
Surya V. Seshan, MD and Billie S. Fyfe, MD

518 Islet Cell Toxicity and Islet Amyloid Deposition
Surya V. Seshan, MD and Billie S. Fyfe, MD
INFECTIONS

520 Intraabdominal and Opportunistic Infections
Surya V. Seshan, MD and Billie S. Fyfe, MD
SECTION 10: VASCULARIZED COMPOSITE ALLOTRANSPLANTATION

528 History of Vascularized Composite Allotransplantation
Linda Cendales, MD
ALLOGRAFT REJECTION

530 Acute T-Cell- and Antibody-Mediated Rejection
A. Brad Farris, III, MD, MBA, Ivy A. Rosales, MD, and Robert B. Colvin, MD

538 Chronic Rejection
A. Brad Farris, III, MD, MBA, Robert B. Colvin, MD, and Ivy A. Rosales, MD
SECTION 11: POSTTRANSPLANT NEOPLASTIC DISORDERS

542 Posttransplant Lymphoproliferative Diseases
A. Brad Farris, III, MD, MBA