Follow-up biopsies with microvascular inflammation and persistent donor specific antibodies identify ongoing rejection in pediatric kidney transplant recipients

23 paediatric recipients with biopsy-proven rejection and a follow-up biopsy. Resolution occurred in 75% of TCMR but only 22% of AbMR and 13% of mixed rejection (p<0.01). Persistent microvascular inflammation predicted future rejection or graft loss (p=0.003). Argues for a protocol follow-up biopsy after rejection treatment.