Thrombotic Microangiopathy in the Renal Allograft: Results of the TMA Banff Working Group Consensus on Pathologic Diagnostic Criteria

被引:10
作者
Afrouzian, Marjan [1 ]
Kozakowski, Nicolas [2 ]
Liapis, Helen [3 ,4 ]
Broecker, Verena [5 ]
Truong, Luon [6 ]
Avila-Casado, Carmen [7 ]
Regele, Heinz [2 ]
Seshan, Surya [8 ]
Ambruzs, Josephine M. [9 ]
Farris, Alton Brad [10 ]
Buob, David [11 ]
Chander, Praveen N. [12 ]
Cheraghvandi, Lukman [13 ]
Clahsen-van Groningen, Marian C. [14 ,15 ]
Araujo, Stanley de Almeida [16 ]
Baydar, Dilek Ertoy [17 ]
Formby, Mark [18 ,19 ]
Ljubanovic, Danica Galesic [20 ]
Hernandez, Loren Herrera [21 ]
Honsova, Eva [22 ]
Mohamed, Nasreen [23 ]
Ozluk, Yasemin [24 ]
Rabant, Marion [25 ]
Royal, Virginie [26 ]
Stevenson, Heather L. [1 ]
Toniolo, Maria Fernanda [27 ]
Taheri, Diana [28 ]
机构
[1] Univ Texas Med Branch Galveston, John Sealy Sch Med, Dept Radiol, Galveston, TX 77555 USA
[2] Med Univ Vienna, Dept Pathol, Vienna, Austria
[3] Washington Univ, Dept Pathol & Immunol, Sch Med, St Louis, MO USA
[4] Ludwig Maximilians Univ Munchen, Dept Nephrol, Munich, Germany
[5] Sahlgrens Univ Hosp, Dept Clin Pathol, Gothenburg, Sweden
[6] Houston Methodist Hosp, Dept Pathol, Houston, TX USA
[7] Univ Hlth Network UHN, Lab Med Program, Toronto, ON, Canada
[8] Weill Cornell Med, Dept Pathol & Lab Med, New York, NY USA
[9] Arkana Labs, Little Rock, AR USA
[10] Emory Univ, Dept Pathol & Lab Med, Atlanta, GA USA
[11] Sorbonne Univ, Assistance Publ Hop Paris, Dept Pathol, Hop Tenon, Paris, France
[12] New York Med Coll, Valhalla, NY USA
[13] Baylor Coll Med, Dept Pathol & Immunol, Houston, TX USA
[14] Univ Med Ctr Rotterdam, Erasmus MC Transplant Inst, Dept Pathol & Clin Bioinformat, Rotterdam, Netherlands
[15] Rhein Westfal TH Aachen, Inst Expt Med & Syst Biol, Aachen, Germany
[16] Univ Fed Minas Gerais, Dept Parasitol, Inst Ciencias Biol, Belo Horizonte, MG, Brazil
[17] Koc Univ, Sch Med, Dept Physiol, Sariyer, Turkiye
[18] NSW Hlth Pathol, Dept Anat Pathol, Sydney, NSW, Australia
[19] Univ Newcastle, Sch Med & Publ Hlth, Callaghan, NSW, Australia
[20] Univ Zagreb, Sch Med, Dept Pathol, Zagreb, Croatia
[21] Mayo Clin, Dept Pathol & Lab Med, Rochester, MN USA
[22] Charles Univ Prague, AeskuLab Pathol & Dept Pathol, Prague, Czech Republic
[23] King Fahad Specialist Hosp Dammam, Dept Pathol & Lab Med, Dammam, Saudi Arabia
[24] Istanbul Univ, Istanbul Fac Med, Dept Pathol, Istanbul, Turkiye
[25] Univ Paris Cite, Necker Enfants Malad Hosp, Dept Pathol, Paris, France
[26] Univ Montreal, Maisonneuve Rosemont Hosp, Dept Pathol, Montreal, PQ, Canada
[27] Inst Nefrol Nephrol, Kidney Pancreas Transplantat, Buenos Aires, Argentina
[28] Isfahan Univ Med Sci, Isfahan Kidney Dis Res Ctr, Dept Pathol, Esfahan, Iran
关键词
thrombotic microangiopathy; kidney; transplant; pathology criteria; Delphi; Banff; ANTIBODY-MEDIATED REJECTION; DELPHI; C4D; TRANSPLANTATION; CLASSIFICATION; EXPRESSION; PROSPECTS;
D O I
10.3389/ti.2023.11590
中图分类号
R61 [外科手术学];
学科分类号
摘要
The Banff community summoned the TMA Banff Working Group to develop minimum diagnostic criteria (MDC) and recommendations for renal transplant TMA (Tx-TMA) diagnosis, which currently lacks standardized criteria. Using the Delphi method for consensus generation, 23 nephropathologists (panelists) with >3 years of diagnostic experience with Tx-TMA were asked to list light, immunofluorescence, and electron microscopic, clinical and laboratory criteria and differential diagnoses for Tx-TMA. Delphi was modified to include 2 validations rounds with histological evaluation of whole slide images of 37 transplant biopsies (28 TMA and 9 non-TMA). Starting with 338 criteria in R1, MDC were narrowed down to 24 in R8 generating 18 pathological, 2 clinical, 4 laboratory criteria, and 8 differential diagnoses. The panelists reached a good level of agreement (70%) on 76% of the validated cases. For the first time in Banff classification, Delphi was used to reach consensus on MDC for Tx-TMA. Phase I of the study (pathology phase) will be used as a model for Phase II (nephrology phase) for consensus regarding clinical and laboratory criteria. Eventually in Phase III (consensus of the consensus groups) and the final MDC for Tx-TMA will be reported to the transplantation community.
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页数:10
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