In general, for anti CD154 treated animals with protocol biopsies at specific time points in the absence of overt signs of renal failure there is no histological signs of renal damage and minimal perivascular immune cell infiltrate and no infiltrate present in tubules or glomeruli (21, 24–26) With treatment withdrawal rejection occurred and immune cell infiltrates were associated with tubulitis, endothelitis, and eventually severe damage of the kidney parenchyma (24, 25). This evidence concerns the gene CD40LG and Renal insufficiency.