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

被引：12

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

来源：

TRANSPLANT INTERNATIONAL | 2023年 / 36卷

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.

引用

页数：10

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