دورية أكاديمية
أعرض في EDS

Acute Antibody-mediated rejection in liver transplantation: Impact and applicability of the Banff working group on liver allograft pathology 2016 criteria.

التفاصيل البيبلوغرافية
العنوان: Acute Antibody-mediated rejection in liver transplantation: Impact and applicability of the Banff working group on liver allograft pathology 2016 criteria.
المؤلفون: Maurice JB; Institute of Liver Studies, King's College Hospital, London SE5 9RS, UK. Electronic address: jamesmaurice@nhs.net., Nwaogu A; Institute of Liver Studies, King's College Hospital, London SE5 9RS, UK. Electronic address: akudo.nwaogu@nhs.net., Gouda M; Institute of Liver Studies, King's College Hospital, London SE5 9RS, UK. Electronic address: mahmoud.gouda@nhs.net., Shaw O; Clinical Transplantation Laboratory, Viapath, Guy's & St Thomas' Hospital, London SE1 9RT, UK. Electronic address: olivia.shaw@nhs.net., Sanchez-Fueyo A; Institute of Liver Studies, King's College Hospital, London SE5 9RS, UK; Department of Liver Sciences, School of Immunology and Infectious Diseases, King's College London, London SE5 9NU, UK. Electronic address: sanchez_fueyo@kcl.ac.uk., Zen Y; Institute of Liver Studies, King's College Hospital, London SE5 9RS, UK. Electronic address: yoh.1.zen@kcl.ac.uk.
المصدر: Human pathology [Hum Pathol] 2022 Sep; Vol. 127, pp. 67-77. Date of Electronic Publication: 2022 Jun 18.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: W B Saunders Country of Publication: United States NLM ID: 9421547 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8392 (Electronic) Linking ISSN: 00468177 NLM ISO Abbreviation: Hum Pathol Subsets: MEDLINE
أسماء مطبوعة: Publication: Philadelphia, PA : W B Saunders
Original Publication: Philadelphia, W B. Saunders Co.
مواضيع طبية MeSH: Kidney Transplantation* , Liver Transplantation*, Adult ; Allografts ; Antibodies ; Biopsy ; Complement C4b ; Graft Rejection ; Humans ; Liver ; Peptide Fragments
مستخلص: This study was aimed to examine the clinical utility and impact of the 2016 Banff criteria for acute antibody-mediated rejection (acute AMR) in patients with liver transplantation. Among adult patients with donor-specific antibody (DSA) assays performed between 2015 and 2020, cases with proved DSA (mean fluorescent index >2000) and matched liver biopsy available were reviewed. Among 55 patients identified, 28 (51%) had class I DSA, 45 (82%) had class II DSA and 18 (33%) had both. Mild, moderate and severe microvasculitis were observed in 11 (20%), 2 (4%) and 1 (2%) case, respectively. Diffuse immunoreactivity to C4d on portal microvascular endothelia was confirmed in 5 cases (9%), which met the criteria of definite (n = 2) or suspicious for acute AMR (n = 3). Cases of acute AMR more commonly had class I DSA (100% vs. 46%; p = 0.027) or both class I and II DSA (80% vs. 28%; p = 0.018) than cases of non-acute AMR. One case of pure acute AMR with veno-occlusion was successfully treated with plasma exchange. The remaining 4 cases had features of combined acute AMR/T cell-mediated rejection (TCMR), and two progressed to ductopenic rejection within 3 weeks. In conclusion, only 9% of DSA-positive patients met the Banff criteria for acute AMR, necessitating careful morphological and immunohistochemical assessments of the allograft biopsies according to the proposed standards. Combined acute AMR/TCMR was more common than isolated acute AMR, and additional AMR in TCMR cases may be associated with rapid progression to ductopenic rejection.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Antibody-mediated rejection; C4d; Donor specific antibody; Ductopenic rejection; Rejection
المشرفين على المادة: 0 (Antibodies)
0 (Peptide Fragments)
80295-50-7 (Complement C4b)
تواريخ الأحداث: Date Created: 20220621 Date Completed: 20220920 Latest Revision: 20221018
رمز التحديث: 20221213
DOI: 10.1016/j.humpath.2022.06.015
PMID: 35728694
قاعدة البيانات: MEDLINE
الوصف
تدمد:1532-8392
DOI:10.1016/j.humpath.2022.06.015