Transplant Pathology

The transplantation of donor organs into patients with end stage organ disease is a lifesaving procedure. However, transplanted organs may develop pathology that results in graft dysfunction in the post-transplant period. This pathology may include rejection (acute or chronic), infection (reactivation or new), reoccurrence of the original disease, newly developed disease (de novo), medication toxicity, or possibly malignancy. A biopsy of the transplanted organ provides valuable information regarding the underlying pathology and assists the clinician with management decisions. The University of Kentucky has active programs for solid organ (kidney, pancreas, heart, lung, and liver) and hematopoietic stem cell transplants. Responsibilities for the interpretation of transplant biopsies in the various organ systems are shared by a group of experienced pathologists in the Department of Pathology and Laboratory Medicine. 

Fritz Lower, MD
Virgilius Cornea, MD
Eun Lee, MD
William O’Connor, MD
Nathan Shelman, MD

All transplant biopsies are evaluated and graded according to standardized criteria established by the Banff Allograft Pathology Foundation and the International Society for Heart and Lung Transplantation. 
Routine staining for C4d is performed on kidney and heart allograft biopsies and on an as needed basis for liver, lung, and pancreas allograft biopsies to assist in the evaluation of antibody mediated rejection.  Preliminary findings are communicated to the ordering provider with a final report issued upon completion
of the evaluation.

First year medical students receive a lecture on Transplant Immunopathology provided by Dr. Fritz Lower.

Pathology residents may take a Transplant Pathology elective lasting one month which allows them to see a variety of solid organ transplant biopsies, learn about Histocompatibility Testing, and attend a variety of transplant patient care meetings.