Böbrek transplantasyonunda ‘97 Banff sınıflandırmasının klinik ve biyokimyasal parametrelerle karşılaştırılması - Banff 2017 sınıflandırması ile hangi kriterler değişti?
Abstract
Amaç: Çalışmamızda, böbrek nakli yapılan olgularda reddetme
tipleri, biyokimyasal bulgular, tedaviye yanıt ve prognozla ilişki araştırıldı.
Banff ‘97 sınıflandırmasından 2017 sınıflandırmasına kadar değişen kriterler
tartışıldı. Yöntem: Ocak 1991-2000
yılları arasında akut rejeksiyon tanısı almış 86 olguya ait68 biyopsi Banff
kriterlerine göre değerlendirildi. Biyopsiler, ilk tanılarına ve Banff
kriterlerine göre Akut Hücresel Rejeksiyon (AHR), Borderline değişiklik (BD) ve
Kronik Allogreft Nefropati (KAN) olarak üç gruba ayrıldı. Tedaviye yanıt,
tedavi sonrası serum kreatinin (SCr)/baseline SCr oranı kullanılarak değerlendirildi.
Rejeksiyon dereceleri interval, biyopsi anındaki SCr düzeyi, delta kreatinin,
proteinüri değeri ile karşılaştırıldı. Bulgular:
Çalışmaya dâhil edilen 168 biyopsiden 92’i (%54.7) akut rejeksiyon tanısı
aldı. Örneklerin 34’ü saf AHR, 31’i BD, 17’si KAN tanısı aldı. Akut rejeksiyon
tanısı alan olgularda rejeksiyon tipi ve biyopsi sonrası tedaviye yanıt
arasında istatistiksel olarak anlamlı fark bulunmadı (p>0.05). BD
olgularında biyopsi öncesi ve tedavi sonrası SCr düzeylerinde arasında istatistiksel
olarak anlamlı fark vardı (p<0.001). Proteinüri ile grade ve KAN arasında
istatistiksel olarak ilişki bulunmadı (p>0.05). Greft süresi, SCr seviyesi,
Delta kreatinin arasında istatistiksel olarak anlamlı fark vardı, (sırasıyla;
p<0.001, p<0.05, p<0.005). Greft kaybı 28 (%16.7) olguda, 213 ile 4836
gün (ortalama 1330) arasında gerçekleşti. Sonuç:
Banff ‘97 sınıflandırmasında yapılan akut ve kronik lezyon skorlarındaki
kriterler ile çalışmamızdaki bulgular uyumlu bulunmuştur. Banff 2017
sınıflandırmasının temelini oluşturan Banff ‘97 sınıflandırmasının, ret
dönüşünü öngörmede çok önemli olan spesifik histolojik yarı-kantitatif
parametreleri doğrulanmıştır. Banff 2017 sınıflandırmasında genetik ve
moleküler yöntemlerin eklenmesiyle, böbrek allogreft histomorfolojisinde son
kriterlerin daha da özelleştiği görülmüştür.
References
- Racusen LC, Halloran PF, Solez K. Banff 2003 meeting report: New diagnostic insights and standards. Am J Transplant 2004;4:1562-1566.
- Haas M, Loupy A, Lefaucher C, Roufosse C, Glotz D, Seron D. et al. The Banff 2017 Kidney Meeting Report: Revised diagnostic criteria for chronic active T cell-mediated rejection, antibody-mediated rejection, and prospects for integrative endpoints for next-generation clinical trials. Am J Transplant 2018;18:293-307.
- Solez K. History of the Banff classification of allogreft pathology as it approaches its 20th year. Current Opinion in Organ Transplantation 2010;15:49-51.
- Solez K, Colvin RB, Racusen LC, Sis B, Halloran PF, Birk PE, et al. Banff ’05 Meeting Report: Differantial Diagnosis of Chronic Allogreft Injury and Elimination of Chronic Allogreft Nephropathy (‘CAN’). Am J Transplant 2007;7:518-526.
- Solez K, Racusen LC. The Banff classification revisited. Kidney International 2013;83:201-206.
- Solez K, Colvin RB, Racusen LC, Haas M, Sis B, Mengel M, et al. Banff 07 Classification of Renal Allogreft Pathology: Updates and Future Directions. Am J Transplant 2008;8:753-760.
- Sis B, Mengel M, Haas M, Colvin RB, Halloran PF, Racusen LC, et al. Banff ’09 Meeting Report: Antibody Mediated Graft Deterioration and Implementation of Banff Working Groups. Am J Transplant 2010;10:464-471.
- Haas M. The Revised (2013) Banff Classification for Antibody-Mediated Rejection of Renal Allogrefts: Update, Diffuculties, and Future Consideration. Am J Transplant 2016;16:1352-1357.
- Gupta RK, Jain M. Histologic grading of acute renal allogreft rejection. Transplant Proc. 1999;31(3):1696-700.
- Browne BJ, Kahan BD. Renal transplantation. Surg Clin North Am 1994;74(5):1097-116.
- Gaber LW, Moore LW, Alloway RR, Flax S, Gaber AO. Correlation between Banff classification, acute renal rejection scores, and reversal of rejection. Transplant Proc 1995;27(1):1019.
- Racusen LC, Solez K, Colvin RB, Bonsib SM, Castro MC, Cavallo T, et al. The Banff 97 working classification of renal allogreft pathology. Kidney Int 1999;55(2):713-23.
- Aikawa A, Miyagi M, Hasegawa A, Ohara T, Hadano T, Nakano H, et al, Glomerular changes in a 1-year posttransplant protocol biopsy as a useful predictive indicator in ABO-incompatible kidney transplantation. Transplant Proc 2000;32(2):301-5.
- Colvin RB, Cohen AH, Saiontz C, Bonsib S, Buick M, Burke B, et al. Evaluation of pathologic criteria for acute renal allogreft rejection: reproducibility, sensitivity, and clinical correlation. J Am Soc Nephrol. 1997;8(12):1930-41.
- Oh CK, Jeong HJ, Kim YS, Kim MS, Choi KH, Lee HY, Han DS, Park K. Clinical validity of Banff grading of chronic rejection in renal transplantation. Transplant Proc. 1996;28(3):1441-2.
- Kokado Y, Kyo M, Takahara S, Ichimaru N, Wang JD, Toki K, Miki T, Okuyama A. Correlation between the Banff classification and reversal of acute renal rejection--Part 1. Transplant Proc 1998;30(1):101-3.
- Gaber LW, Moore LW, Alloway RR, Flax SD, Shokouh-Amiri MH, Schroder T, Gaber AO. Correlation between Banff classification, acute renal rejection scores and reversal of rejection. Kidney Int 1996;49(2):481-7.
- Lorriaux C, Pouteil Noble C, Dijoud F, Cahen R, Touraine JL, MacGregor B. Clinical correlation of acute rejection according to Banff classification in renal transplantation. Transplant Proc 2000;32(2):443-4.
- Minervini MI, Torbenson M, Scantlebury V, Vivas C, Jordan M, Shapiro R, Randhawa PS. Acute renal allogreft rejection with severe tubulitis (Banff 1997 grade IB). Am J Surg Pathol. 2000;24(4):553-8.
- Nickeleit V, Vamvakas EC, Pascual M, Poletti BJ, Colvin RB. The prognostic significance of specific arterial lesions in acute renal allogreft rejection. J Am Soc Nephrol 1998;9(7):1301-8.
- Mengel M, Gwinner W, Schwarz A, Bajeski R, Franz I, Bröker V, et al. Infiltrates in protocol biopsies from renal allogrefts. Am J Transpalnt 2007;7:356-365
- Castellanos FER, Quintana FD, Abraham VS, Urrea EM. Classification of Acute Rejection Episodes in Kidney Transplantation. Iranian Journal of Kidney Diseases 2018;12(2):123-130
- Almasi-Hashiani A, Rajaeefard AR, Hassanzade J, Salahi H, Nikeghbalian S, Janghorban P, Malek-Hosseini SA. Graft Survival Rate of Renal Transplantation: A Single Center Experience, (1999-2009) Iran Red Crescent Med J 2011; 13(6):392-397
Abstract
References
- Racusen LC, Halloran PF, Solez K. Banff 2003 meeting report: New diagnostic insights and standards. Am J Transplant 2004;4:1562-1566.
- Haas M, Loupy A, Lefaucher C, Roufosse C, Glotz D, Seron D. et al. The Banff 2017 Kidney Meeting Report: Revised diagnostic criteria for chronic active T cell-mediated rejection, antibody-mediated rejection, and prospects for integrative endpoints for next-generation clinical trials. Am J Transplant 2018;18:293-307.
- Solez K. History of the Banff classification of allogreft pathology as it approaches its 20th year. Current Opinion in Organ Transplantation 2010;15:49-51.
- Solez K, Colvin RB, Racusen LC, Sis B, Halloran PF, Birk PE, et al. Banff ’05 Meeting Report: Differantial Diagnosis of Chronic Allogreft Injury and Elimination of Chronic Allogreft Nephropathy (‘CAN’). Am J Transplant 2007;7:518-526.
- Solez K, Racusen LC. The Banff classification revisited. Kidney International 2013;83:201-206.
- Solez K, Colvin RB, Racusen LC, Haas M, Sis B, Mengel M, et al. Banff 07 Classification of Renal Allogreft Pathology: Updates and Future Directions. Am J Transplant 2008;8:753-760.
- Sis B, Mengel M, Haas M, Colvin RB, Halloran PF, Racusen LC, et al. Banff ’09 Meeting Report: Antibody Mediated Graft Deterioration and Implementation of Banff Working Groups. Am J Transplant 2010;10:464-471.
- Haas M. The Revised (2013) Banff Classification for Antibody-Mediated Rejection of Renal Allogrefts: Update, Diffuculties, and Future Consideration. Am J Transplant 2016;16:1352-1357.
- Gupta RK, Jain M. Histologic grading of acute renal allogreft rejection. Transplant Proc. 1999;31(3):1696-700.
- Browne BJ, Kahan BD. Renal transplantation. Surg Clin North Am 1994;74(5):1097-116.
- Gaber LW, Moore LW, Alloway RR, Flax S, Gaber AO. Correlation between Banff classification, acute renal rejection scores, and reversal of rejection. Transplant Proc 1995;27(1):1019.
- Racusen LC, Solez K, Colvin RB, Bonsib SM, Castro MC, Cavallo T, et al. The Banff 97 working classification of renal allogreft pathology. Kidney Int 1999;55(2):713-23.
- Aikawa A, Miyagi M, Hasegawa A, Ohara T, Hadano T, Nakano H, et al, Glomerular changes in a 1-year posttransplant protocol biopsy as a useful predictive indicator in ABO-incompatible kidney transplantation. Transplant Proc 2000;32(2):301-5.
- Colvin RB, Cohen AH, Saiontz C, Bonsib S, Buick M, Burke B, et al. Evaluation of pathologic criteria for acute renal allogreft rejection: reproducibility, sensitivity, and clinical correlation. J Am Soc Nephrol. 1997;8(12):1930-41.
- Oh CK, Jeong HJ, Kim YS, Kim MS, Choi KH, Lee HY, Han DS, Park K. Clinical validity of Banff grading of chronic rejection in renal transplantation. Transplant Proc. 1996;28(3):1441-2.
- Kokado Y, Kyo M, Takahara S, Ichimaru N, Wang JD, Toki K, Miki T, Okuyama A. Correlation between the Banff classification and reversal of acute renal rejection--Part 1. Transplant Proc 1998;30(1):101-3.
- Gaber LW, Moore LW, Alloway RR, Flax SD, Shokouh-Amiri MH, Schroder T, Gaber AO. Correlation between Banff classification, acute renal rejection scores and reversal of rejection. Kidney Int 1996;49(2):481-7.
- Lorriaux C, Pouteil Noble C, Dijoud F, Cahen R, Touraine JL, MacGregor B. Clinical correlation of acute rejection according to Banff classification in renal transplantation. Transplant Proc 2000;32(2):443-4.
- Minervini MI, Torbenson M, Scantlebury V, Vivas C, Jordan M, Shapiro R, Randhawa PS. Acute renal allogreft rejection with severe tubulitis (Banff 1997 grade IB). Am J Surg Pathol. 2000;24(4):553-8.
- Nickeleit V, Vamvakas EC, Pascual M, Poletti BJ, Colvin RB. The prognostic significance of specific arterial lesions in acute renal allogreft rejection. J Am Soc Nephrol 1998;9(7):1301-8.
- Mengel M, Gwinner W, Schwarz A, Bajeski R, Franz I, Bröker V, et al. Infiltrates in protocol biopsies from renal allogrefts. Am J Transpalnt 2007;7:356-365
- Castellanos FER, Quintana FD, Abraham VS, Urrea EM. Classification of Acute Rejection Episodes in Kidney Transplantation. Iranian Journal of Kidney Diseases 2018;12(2):123-130
- Almasi-Hashiani A, Rajaeefard AR, Hassanzade J, Salahi H, Nikeghbalian S, Janghorban P, Malek-Hosseini SA. Graft Survival Rate of Renal Transplantation: A Single Center Experience, (1999-2009) Iran Red Crescent Med J 2011; 13(6):392-397
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | August 15, 2018 |
| Submission Date | May 3, 2018 |
| Acceptance Date | July 26, 2018 |
| Published in Issue | Year 2018 Volume: 11 Issue: 2 |
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