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A 2020 Banff Antibody-mediatedInjury Working Group examination of international practices for diagnosing antibody-mediated rejection in kidney transplantation - a cohort study.

Publication ,  Journal Article
Schinstock, CA; Askar, M; Bagnasco, SM; Batal, I; Bow, L; Budde, K; Campbell, P; Carroll, R; Clahsen-van Groningen, MC; Cooper, M; Cornell, LD ...
Published in: Transpl Int
March 2021

The Banff antibody-mediated rejection (ABMR) classification is vulnerable to misinterpretation, but the reasons are unclear. To better understand this vulnerability, we evaluated how ABMR is diagnosed in practice. To do this, the Banff Antibody-Mediated Injury Workgroup electronically surveyed an international cohort of nephrologists/surgeons (n = 133) and renal pathologists (n = 99). Most providers (97%) responded that they use the Banff ABMR classification at least sometimes, but DSA information is often not readily available. Only 41.1% (55/133) of nephrologists/surgeons and 19.2% (19/99) of pathologists reported that they always have DSA results when the biopsy is available. Additionally, only 19.6% (26/133) of nephrologists/surgeons responded that non-HLA antibody or molecular transcripts are obtained when ABMR histologic features are present but DSA is undetected. Several respondents agreed that histologic features concerning for ABMR in the absence of DSA and/or C4d are not well accounted for in the current classification [31.3% (31/99) pathologists and 37.6% (50/133) nephrologist/surgeons]. The Banff ABMR classification appears widely accepted, but efforts to improve the accessibility of DSA information for the multidisciplinary care team are needed. Further clarity is also needed in Banff ABMR nomenclature to account for the spectrum of ABMR and for histologic features suspicious for ABMR when DSA is absent.

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Published In

Transpl Int

DOI

EISSN

1432-2277

Publication Date

March 2021

Volume

34

Issue

3

Start / End Page

488 / 498

Location

Switzerland

Related Subject Headings

  • Surgery
  • Kidney Transplantation
  • Isoantibodies
  • Humans
  • Graft Rejection
  • Cohort Studies
  • Allografts
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Schinstock, C. A., Askar, M., Bagnasco, S. M., Batal, I., Bow, L., Budde, K., … Kraus, E. S. (2021). A 2020 Banff Antibody-mediatedInjury Working Group examination of international practices for diagnosing antibody-mediated rejection in kidney transplantation - a cohort study. Transpl Int, 34(3), 488–498. https://doi.org/10.1111/tri.13813
Schinstock, Carrie A., Medhat Askar, Serena M. Bagnasco, Ibrahim Batal, Laurine Bow, Klemens Budde, Patricia Campbell, et al. “A 2020 Banff Antibody-mediatedInjury Working Group examination of international practices for diagnosing antibody-mediated rejection in kidney transplantation - a cohort study.Transpl Int 34, no. 3 (March 2021): 488–98. https://doi.org/10.1111/tri.13813.
Schinstock, Carrie A., et al. “A 2020 Banff Antibody-mediatedInjury Working Group examination of international practices for diagnosing antibody-mediated rejection in kidney transplantation - a cohort study.Transpl Int, vol. 34, no. 3, Mar. 2021, pp. 488–98. Pubmed, doi:10.1111/tri.13813.
Schinstock CA, Askar M, Bagnasco SM, Batal I, Bow L, Budde K, Campbell P, Carroll R, Clahsen-van Groningen MC, Cooper M, Cornell LD, Cozzi E, Dadhania D, Diekmann F, Hesselink DA, Jackson AM, Kikic Z, Lower F, Naesens M, Roelofs JJ, Sapir-Pichhadze R, Kraus ES. A 2020 Banff Antibody-mediatedInjury Working Group examination of international practices for diagnosing antibody-mediated rejection in kidney transplantation - a cohort study. Transpl Int. 2021 Mar;34(3):488–498.
Journal cover image

Published In

Transpl Int

DOI

EISSN

1432-2277

Publication Date

March 2021

Volume

34

Issue

3

Start / End Page

488 / 498

Location

Switzerland

Related Subject Headings

  • Surgery
  • Kidney Transplantation
  • Isoantibodies
  • Humans
  • Graft Rejection
  • Cohort Studies
  • Allografts
  • 3202 Clinical sciences
  • 1103 Clinical Sciences