The Banff schema for antibody-mediated rejection: Lost in translation?
| Autor: | Roslyn B. Mannon |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Graft Rejection
Transplantation business.industry Banff schema Translation (biology) 030230 surgery Kidney Transplantation Article 03 medical and health sciences 0302 clinical medicine Isoantibodies Surveys and Questionnaires Immunology Antibody mediated rejection Immunology and Allergy Medicine Pharmacology (medical) 030212 general & internal medicine business |
| Zdroj: | American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 19(1) |
| ISSN: | 1600-6143 |
| Popis: | The aim of this study was to determine how the Banff antibody-mediated rejection (ABMR) classification for kidney transplantation is interpreted in practice and impacts therapy. The Banff Antibody-Mediated Injury Workgroup electronically surveyed clinicians and pathologists worldwide regarding diagnosis and treatment for six case-based scenarios. The participants’ (95 clinicians and 72 renal pathologists) assigned diagnoses were compared to the Banff intended diagnoses (reference standard). The assigned diagnoses and reference standard differed by 26.1% (SD 28.1%) for pathologists and 34.5%(SD 23.3%) for clinicians. The greatest discordance between the reference standard and clinicians’ diagnosis was when histologic features of ABMR were present but donor-specific antibody was undetected [49.4%(43/87)]. For pathologists, the greatest discordance was in the case of acute/active ABMR C4d staining negative in a positive crossmatch transplant recipient[33.8%(23/68)]. Treatment approaches were heterogeneous, but linked to the assigned diagnosis. When acute/active ABMR was diagnosed by the clinician, treatment was recommended 95.3%(SD 18.4%) of the time versus only 77.7%(SD 39.2%) of the time when chronic active ABMR was diagnosed (P |
| Databáze: | OpenAIRE |
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