American Board of Surgery Qualifying Exam (ABS QE) Practice Test

Which findings are indicative of chronic kidney transplant rejection?

1. Air trapping on expiration

2. Vanishing bile duct syndrome

3. Interstitial fibrosis and tubular atrophy

4. Vasculopathy

The correct answer is: Interstitial fibrosis and tubular atrophy

Chronic kidney transplant rejection is characterized by specific histopathological findings that indicate enduring damage to the transplanted organ. One of the hallmark findings is interstitial fibrosis and tubular atrophy. This refers to the scarring and loss of function in the kidney's interstitial tissue and the tubules, leading to a gradual decline in kidney function over time as the body attempts to reject the transplant. Now, while other options may pertain to different medical conditions or results not directly tied to chronic kidney transplant rejection, interstitial fibrosis and tubular atrophy specifically highlight the long-term repercussions of chronic rejection processes, which may be related to various factors such as chronic allograft injury or previous episodes of acute rejection. This progressive atrophy is associated with a poor prognosis for the transplanted kidney, thus making it a key finding in diagnosing chronic rejection.