Does the definition of chronic active T-cell mediated rejection need revisiting?

Similar to what is observed in native kidneys, tubulo-interstitial inflammation in scarred areas (i-IFTA) is commonly found in kidney allografts, and here independently associated with impaired outcome. Along with the observation that i-IFTA is preceded by acute T cell mediated rejection (TCMR) and/or suboptimal immunosuppression in a subset of cases, these data formed the basis for the introduction of the category of tubulointerstitial (grade I) chronic active TCMR (CA-TCMR) in the 2017 Banff classification.