Neglected no longer: lymphatic vessels in the rejecting allograft

As short-term kidney transplant outcomes have improved, and donor and recipient demographics have shifted, the causes of allograft loss have become more complex. Late graft loss (more than one-year post-transplant) is often caused by more than one factor, and rejecting grafts can exhibit complex pathologies. Understanding how complex pathologies, including mixed T cell and antibody-mediated rejection, arise in some transplant recipients, and why other recipients tolerate their transplants long-term, is important to now improve long-term outcomes. One likely modulator of chronic immune responses in the kidney is the lymphatic system. However, these fragile, thin-walled vessels are difficult to study and have received less attention than their blood-transporting counterparts.