FIGURE 2.

Proposed model for future research into pathogenesis of DAIH. Acute rejection episodes may prime the immune system to mount a self-directed response. Acute rejection is initiated by the large number of recipient T cells that recognize donor alloantigens encoded by MHC.^125,126 Alloantigen presentation may be via direct pathway or indirect pathway.¹²⁷ Graft injury reveals previously unseen epitopes. IL-17 would contribute to an inflammatory milieu and lead to the production of antibodies by B cells. In the absence of other negative regulatory mechanisms, this possibly contributes to the development of autoimmunity.