The time to onset of transplant rejection may indicate the underlying mechanism.
Time to Onset
Type
immediate to hours
hyperacute
few days
accelerated
several days to weeks
acute
months to years
chronic
A person with chronic rejection can have episodes of superimposed acute disease if immunosuppressive therapy is interrupted or an appropriate stimulus occurs.
Type
Pathophysiology
hyperacute
circulating antibodies to donor antigens with activation of complement; active sensitized T lymphocytes
accelerated
reactivation of previously sensitized T lymphocytes
acute
primary activation of T lymphocytes
chronic
low grade immune reaction in a setting of immunosuppressive therapy
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