A: A representative recipient in the TOL group showed no evidence of rejection on days 133 (upper left), 393 (upper right), 3478 (lower left), and 4115 (lower right) post-DBMT. A minimal infiltrate in a focal area of fibrosis was present at day 3478.
B. A recipient in the CAMR group showed minimal interstitial infiltrate and focal capillaritis without C4d deposition on days 141 (upper left) and 629 post-DBMT (upper right). (right upper panel). Transplant glomerulopathy and glomerulitis without C4d deposition was present at d1036 post-DBMT (lower left). Extensive transplant glomerulopathy and focal C4d deposition (not shown) was present at day 1825 post-DBMT (lower right). This was associated with the development of DSA.
C: A recipient that initially developed a low level of chimerism developed TCMR with dense interstitial inflammation and tubulitis on day 90 post-DBMT (left upper panel) and then progressed to terminal acute cellular rejection (Banff Type II: g0, i3, t2, v*, cg0, ci0, ct0, cv0, ptc0, C4d0) characterized by extensive interstitial inflammation, edema, tubulitis, and endarteritis (not shown) without C4d depositions on d125 post-DBMT (right upper panel). A recipient that failed to develop mixed chimerism developed acute cellular rejection (Banff Type I: g3, i3, t3, v*, cg, ci0, ct0, cv0, ptc2, C4d0) without C4d deposition at d62 post-DBMT, right after serum cyclosporine became undetectable (lower panels).