2013 Banff Criteria for Chronic Active Antibody-Mediated Rejection: Assessment in a Real-Life Setting

被引:29
作者
De Serres, S. A. [1 ]
Noel, R. [1 ]
Cote, I. [1 ]
Lapointe, I. [1 ]
Wagner, E. [2 ]
Riopel, J. [3 ]
Latulippe, E. [3 ]
Agharazii, M. [1 ]
Houde, I. [1 ]
机构
[1] Univ Laval, Fac Med, Univ Hlth Ctr Quebec, Transplantat Unit,Renal Div,Dept Med, Quebec City, PQ G1K 7P4, Canada
[2] Univ Laval, Fac Med, Univ Hlth Ctr Quebec, Immunol & Histocompatibil Lab, Quebec City, PQ G1K 7P4, Canada
[3] Univ Laval, Fac Med, Univ Hlth Ctr Quebec, Dept Pathol, Quebec City, PQ G1K 7P4, Canada
关键词
DONOR-SPECIFIC ANTIBODIES; KIDNEY-TRANSPLANT RECIPIENTS; RENAL-ALLOGRAFTS; PERITUBULAR CAPILLARITIS; DIAGNOSTIC CHALLENGES; PROTOCOL BIOPSIES; C4D; GLOMERULOPATHY; PATHOLOGY; FAILURE;
D O I
10.1111/ajt.13624
中图分类号
R61 [外科手术学];
学科分类号
摘要
Significant changes in the criteria for chronic active antibody-mediated rejection (CAABMR) were made in the Banff 2013 classification. These modifications expanded the number of patients diagnosed with CAABMR, with undetermined clinical significance. We compared the 2007 and 2013 criteria for the composite end point of death-censored graft failure or doubling of serum creatinine in 123 patients meeting the criterion related to the morphologic evidence of chronic tissue injury. In all, 18% and 36% of the patients met the 2007 and 2013 criteria, respectively. For the criterion related to antibody interaction with endothelium, only 25% were positive based on the 2007 definition compared with 82% using the 2013 definition. Cox modeling revealed that a 2013 but not a 2007 diagnosis was associated with the composite end point (adjusted hazard ratio 2.5 [95% confidence interval (CI) 1.2-5.2] vs. 1.6 [95% CI 0.7-3.8], respectively). The 2013 criterion based on both the C4d score and the glomerulitis plus peritubular capillaritis score (g+ptc) was more strongly associated with the end point than the 2007 criterion based only on C4d; however, when dissected by component, only the C4d component was significant. The association with clinical outcomes improved with the 2013 criteria. This is related to the new C4d threshold but not to the g+ptc 2 component. The authors compare the association between clinical outcomes and Banff 2007 versus 2013 criteria for chronic active antibody-mediated kidney rejection, with a particular focus on the C4d and g+ptc components. See also the minireview from Haas on page 1352.
引用
收藏
页码:1516 / 1525
页数:10
相关论文
共 36 条
[1]  
[Anonymous], 2014, 2014 CORR ANN REPORT
[2]   Diagnosis and Management of Antibody-Mediated Rejection: Current Status and Novel Approaches [J].
Djamali, A. ;
Kaufman, D. B. ;
Ellis, T. M. ;
Zhong, W. ;
Matas, A. ;
Samaniego, M. .
AMERICAN JOURNAL OF TRANSPLANTATION, 2014, 14 (02) :255-271
[3]   Increased C4d in post-reperfusion biopsies and increased donor specific antibodies at one-week post transplant are risk factors for acute rejection in mild to moderately sensitized kidney transplant recipients [J].
Djamali, Arjang ;
Muth, Brenda L. ;
Ellis, Thomas M. ;
Mohamed, Maha ;
Fernandez, Luis A. ;
Miller, Karen M. ;
Bellingham, Janet M. ;
Odorico, Jon S. ;
Mezrich, Joshua D. ;
Pirsch, John D. ;
D'Alessandro, Tony M. ;
Vidyasagar, Vijay ;
Hofmann, R. Michael ;
Torrealba, Jose R. ;
Kaufman, Dixon B. ;
Foley, David P. .
KIDNEY INTERNATIONAL, 2013, 83 (06) :1185-1192
[4]   Antibody-Mediated Microcirculation Injury Is the Major Cause of Late Kidney Transplant Failure [J].
Einecke, G. ;
Sis, B. ;
Reeve, J. ;
Mengel, M. ;
Campbell, P. M. ;
Hidalgo, L. G. ;
Kaplan, B. ;
Halloran, P. F. .
AMERICAN JOURNAL OF TRANSPLANTATION, 2009, 9 (11) :2520-2531
[5]   Identifying Specific Causes of Kidney Allograft Loss [J].
El-Zoghby, Z. M. ;
Stegall, M. D. ;
Lager, D. J. ;
Kremers, W. K. ;
Amer, H. ;
Gloor, J. M. ;
Cosio, F. G. .
AMERICAN JOURNAL OF TRANSPLANTATION, 2009, 9 (03) :527-535
[6]   Diagnostic challenges in chronic antibody-mediated rejection [J].
Farkash, Evan A. ;
Colvin, Robert B. .
NATURE REVIEWS NEPHROLOGY, 2012, 8 (05) :255-257
[7]   Evidence for Antibody-Mediated Injury as a Major Determinant of Late Kidney Allograft Failure [J].
Gaston, Robert S. ;
Cecka, J. Michael ;
Kasiske, Bert L. ;
Fieberg, Ann M. ;
Leduc, Robert ;
Cosio, Fernando C. ;
Gourishankar, Sita ;
Grande, Joseph ;
Halloran, Philip ;
Hunsicker, Lawrence ;
Mannon, Roslyn ;
Rush, David ;
Matas, Arthur J. .
TRANSPLANTATION, 2010, 90 (01) :68-74
[8]   Peritubular capillaritis in renal allografts: Prevalence, scoring system, reproducibility and clinicopathological correlates [J].
Gibson, I. W. ;
Gwinner, W. ;
Brocker, V. ;
Sis, B. ;
Riopel, J. ;
Roberts, I. S. D. ;
Scheffner, I. ;
Jhangri, G. S. ;
Mengel, M. .
AMERICAN JOURNAL OF TRANSPLANTATION, 2008, 8 (04) :819-825
[9]   Banff 2013 Meeting Report: Inclusion of C4d-Negative Antibody-Mediated Rejection and Antibody-Associated Arterial Lesions [J].
Haas, M. ;
Sis, B. ;
Racusen, L. C. ;
Solez, K. ;
Glotz, D. ;
Colvin, R. B. ;
Castro, M. C. R. ;
David, D. S. R. ;
David-Neto, E. ;
Bagnasco, S. M. ;
Cendales, L. C. ;
Cornell, L. D. ;
Demetris, A. J. ;
Drachenberg, C. B. ;
Farver, C. F. ;
Farris, A. B., III ;
Gibson, I. W. ;
Kraus, E. ;
Liapis, H. ;
Loupy, A. ;
Nickeleit, V. ;
Randhawa, P. ;
Rodriguez, E. R. ;
Rush, D. ;
Smith, R. N. ;
Tan, C. D. ;
Wallace, W. D. ;
Mengel, M. .
AMERICAN JOURNAL OF TRANSPLANTATION, 2014, 14 (02) :272-283
[10]   Early Ultrastructural Changes in Renal Allografts: Correlation With Antibody-Mediated Rejection and Transplant Glomerulopathy [J].
Haas, M. ;
Mirocha, J. .
AMERICAN JOURNAL OF TRANSPLANTATION, 2011, 11 (10) :2123-2131