Delphi: A Democratic and Cost-Effective Method of Consensus Generation in Transplantation

被引：4

作者：

Afrouzian, Marjan ^{[1
]}

Kozakowski, Nicolas ^{[2
]}

Liapis, Helen ^{[3
,4
]}

Broecker, Verena ^{[5
]}

Truong, Luan ^{[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
,23
]}

Mohamed, Nasreen ^{[24
]}

Ozluk, Yasemin ^{[25
]}

Rabant, Marion ^{[26
]}

Royal, Virginie ^{[27
]}

Stevenson, Heather L. ^{[1
]}

Toniolo, Maria Fernanda ^{[28
]}

Taheri, Diana ^{[29
]}

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 St Louis, Sch Med, Dept Pathol & Immunol, St Louis, MO USA

[4] Ludwig Maximilian Univ Munich, GeoBio Ctr, Munich, Germany

[5] Sahlgrens Univ Hosp, Dept Clin Microbiol, Gothenburg, Sweden

[6] Houston Methodist Hosp, Dept Pathol & Genom Med, Houston, TX USA

[7] Univ Hlth Network UHN, Krembil Brain Inst, 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] Univ Sorbonne, Hop Tenon, Assistance Publ Hop Paris, Dept Pathol, Paris, France

[12] New York Med Coll, Valhalla, NY USA

[13] Baylor Coll Med, Dept Pathol & Immunol, Houston, TX USA

[14] Erasmus MC Transplant Inst, Univ Med Ctr Rotterdam, Dept Pathol & Clin Bioinformat, Rotterdam, Netherlands

[15] Univ Hosp RWTH Aachen, Inst Cell & Tumor Biol, Aachen, Germany

[16] Univ Fed Minas Gerais, Dept Patol Geral, Inst Ciencias Biol, Belo Horizonte, Brazil

[17] Koc Univ, Sch Med, Dept Neurol, Istanbul, Turkiye

[18] NSW Hlth Pathol, Dept Anat Pathol, Callaghan, NSW, Australia

[19] Univ Newcastle, Coll Hlth Med & Wellbeing, Sch Med & Publ Hlth, Callaghan, NSW, Australia

[20] Univ Zagreb, Sch Med, Dept Pathol, Zagreb, Croatia

[21] Mayo Clin, Dept Lab Med & Pathol, Rochester, MN USA

[22] Charles Univ Prague, AeskuLab Pathol, Prague, Czech Republic

[23] Charles Univ Prague, Dept Pathol, Prague, Czech Republic

[24] King Fahad Specialist Hosp Dammam, Dept Pathol & Lab Med, Dammam, Saudi Arabia

[25] Istanbul Univ, Istanbul Fac Med, Dept Pathol, Istanbul, Turkiye

[26] Univ Paris Cite, Necker Enfants Malad Hosp, Dept Pathol, Paris, France

[27] Univ Montreal, Maisonneuve Rosemont Hosp, Dept Pathol, Montreal, PQ, Canada

[28] Inst Nefrol Nephrol, Kidney Pancreas Transplantat, Buenos Aires, Argentina

[29] Isfahan Univ Med Sci, Isfahan Kidney Dis Res Ctr, Dept Pathol, Esfahan, Iran

来源：

TRANSPLANT INTERNATIONAL | 2023年 / 36卷

关键词：

Delphi; Banff; thrombotic microangiopathy; kidney; transplantation; CRITERIA; REJECTION; CLASSIFICATION; PROSPECTS;

D O I：

10.3389/ti.2023.11589

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

The Thrombotic Microangiopathy Banff Working Group (TMA-BWG) was formed in 2015 to survey current practices and develop minimum diagnostic criteria (MDC) for renal transplant TMA (Tx-TMA). To generate consensus among pathologists and nephrologists, the TMA BWG designed a 3-Phase study. Phase I of the study is presented here. Using the Delphi methodology, 23 panelists with >3 years of diagnostic experience with Tx-TMA pathology listed their MDC suggesting light, immunofluorescence, and electron microscopy lesions, clinical and laboratory information, and differential diagnoses. Nine rounds (R) of consensus resulted in MDC validated during two Rs using online evaluation of whole slide digital images of 37 biopsies (28 TMA, 9 non-TMA). Starting with 338 criteria the process resulted in 24 criteria and 8 differential diagnoses including 18 pathologic, 2 clinical, and 4 laboratory criteria. Results show that 3/4 of the panelists agreed on the diagnosis of 3/4 of cases. The process also allowed definition refinement for 4 light and 4 electron microscopy lesions. For the first time in Banff classification, the Delphi methodology was used to generate consensus. The study shows that Delphi is a democratic and cost-effective method allowing rapid consensus generation among numerous physicians dealing with large number of criteria in transplantation.

引用

页数：10

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