The acute humoral rejection is also currently put into two subclasses, peritubular capillary and arterial, since these are the distinctive vascular beds that are involved. Either case, there is antibodies mount immunity against endothelial cells. Cohen (2007) describes that acute tubular injury is a third form of tubular injury that is often encountered. To positively diagnose humoral rejection, it is necessary to identify C4d, which is a product of C4 which is involved in the complement system. After the antibody binds to the antigen, C4 fixation occurs and activated C1 cleaves C4 into C4a and C4b.
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