According to Cohen (2007), the commonest location for acute cell-mediated rejection is the tubulo-interstitial rejection and it is also the most frequent form of T-cell mediated rejection. There is notable accumulation of T lymphocytes in the interstitium though it is primarily in the tubular capillaries. The epithelial cells are commonly damaged in addition to destruction of tubular walls. Also common in the acute cell mediated rejection is the presence of the interstitial foci of Tamm-Horsfall protein as well as the subclinical rejection process as presented by transplant biopsies.
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