scholarly journals 30 years of the International Banff Classification for Allograft Pathology: The Past, Present and Future of Kidney Transplant Diagnostics

2021 ◽  
Author(s):  
Alexandre Loupy ◽  
Michael Mengel ◽  
Mark Haas
Keyword(s):  
Kidney Transplant ◽  
The Past ◽  
Banff Classification

scholarly journals 50-year history of kidney transplantation in Hungary

2013 ◽  
Vol 154 (22) ◽  
pp. 846-849 ◽  
Author(s):  
Edit Szederkényi ◽  
Pál Szenohradszky ◽  
Ernő Csajbók ◽  
Ferenc Perner ◽  
László Asztalos ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Graft Rejection ◽  
Full Membership ◽  
Ministry Of Health ◽  
The Past ◽  
Transplant Program ◽  
History Of ◽  
Patient Groups ◽  
Special Patient

The first Hungarian kidney transplantation was performed by András Németh in Szeged in 1962, approximately 50 years ago. A preliminary agreement with Eurotransplant was signed in 2011, and special patient groups gained benefit from this cooperation in 2012, wnich lead to a full membership to Eurotransplant. This event inspired the authors to review the history of Hungarian kidney transplantation of the past 50 years, from the first operation to recent via the specific cornerstones of the transplant program. The donor of the first Hungarian kidney transplantation was the brother of the recipient. The operation itself was technically successful, but the lack of immunosuppression caused graft rejection, and the patient died after 79 days. His brother, the donor, is still healthy, after 50 years, and he encourages everybody to donate organs. Organized kidney transplant program started more than 10 years later, such as 1973, in Budapest. The program was supported by the Ministry of Health. New centers joined the program later, Szeged in 1979, Debrecen in 1991 and Pécs in 1993. These four transplant centers work currently in Hungary, and 6611 kidney transplantation has been performed up to the end of year 2012. Orv. Hetil., 2013, 154, 846–849.

scholarly journals Changing Attitudes Toward Influenza Vaccination in U.S. Kidney Transplant Programs Over the Past Decade

2010 ◽  
Vol 5 (9) ◽  
pp. 1637-1641 ◽  
Author(s):  
W. James Chon ◽  
Pradeep V. Kadambi ◽  
Robert C. Harland ◽  
J. Richard Thistlethwaite ◽  
Bradford L. West ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Kidney Transplant ◽  
The Past ◽  
Changing Attitudes

MO1001THE OUTCOME OF PLASMA CELL-RICH ACUTE REJECTION IN KIDNEY TRANSPLANTATION, IS IT REALLY POOR?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Tarek S H Mahmoud ◽  
Osama Gheith ◽  
Jude Yagan ◽  
Ahmad Al-Taleb ◽  
Medhat MA Halim ◽  
...  
Keyword(s):  
T Cell ◽  
Acute Rejection ◽  
Kidney Transplant ◽  
Plasma Cell ◽  
Membranous Nephropathy ◽  
Post Treatment ◽  
Hla Typing ◽  
Antibody Mediated Rejection ◽  
Banff Classification ◽  
Associated Conditions

Abstract Background and Aims The outcome of Plasma cell-rich acute rejection (PCAR) in kidney transplant is reported to be poor. However, PCAR which can be associated with any type of rejection, may not be considered as independent morphological prognostic feature. Different treatment modalities were prescribed with variable responses. We report here four cases of PCAR and describe their presentations, type of rejection, associated conditions and treatment outcome. Method Out of 1920 kidney transplant recipients under follow up in our centre from 1996 till 2019, four patients were reported to have PCAR according to 2007 Banff classification. They were re-evaluated based on 2015 Banff classification. The treatment protocol was tailored according to the type of rejection and associated conditions. Results The four patients, aged 28, 44, 46 and 54 years, had live unrelated renal transplant done somewhere abroad with no data about donor HLA typing. Two of them were females. One had high PRA and she was positive for HBsAg. One patient received induction immunosuppression with basiliximab. They all received prednisolone, mycophenolate and cyclosporine as the maintenance immunosuppression and had immediate graft function. Rejection happened between 23 to 180 months post-transplant. Two patients had acute T-cell mediated Banff 1A rejections with features consistent with early membranous nephropathy. One had acute T-cell mediated rejection Banff 1B and the fourth had borderline T-cell mediated rejection with morphological changes suggestive of chronic active antibody mediated rejection (AMR). Plasma cells constituted 10 to 30% of the interstitial infiltration. All patients received solumedrol pulse. Both patients with features of membranous nephropathy received rituximab and one of them had additionally IVIG. The patient with AMR received plasma exchange and IVIG. However, she did not receive rituximab as she was positive for HBsAg. All patients responded well to treatment and the mean improvement in eGFR was 12.8%, 24.9%, 40.3% and 39.1% at 1-, 3-, 6- and 12-months post treatment. Repeat kidney biopsy at 3 to 12 weeks post treatment showed resolution of plasma cell infiltration in all patients. Conclusion Outcome of PCAR management was favourable among our patients irrespective of the type of rejection and associated conditions.

scholarly journals Data-driven Derivation and Validation of Novel Phenotypes for Acute Kidney Transplant Rejection using Semi-supervised Clustering

2021 ◽  
pp. ASN.2020101418
Author(s):  
Thibaut Vaulet ◽  
Gillian Divard ◽  
Olivier Thaunat ◽  
Evelyne Lerut ◽  
Aleksandar Senev ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Graft Failure ◽  
Transplant Rejection ◽  
Data Driven ◽  
Adjusted Rand Index ◽  
Additional Information ◽  
Banff Classification ◽  
Data Driven Approach ◽  
Consensus Classification ◽  
Semisupervised Clustering

BackgroundOver the past decades, an international group of experts iteratively developed a consensus classification of kidney transplant rejection phenotypes, known as the Banff classification. Data-driven clustering of kidney transplant histologic data could simplify the complex and discretionary rules of the Banff classification, while improving the association with graft failure.MethodsThe data consisted of a training set of 3510 kidney-transplant biopsies from an observational cohort of 936 recipients. Independent validation of the results was performed on an external set of 3835 biopsies from 1989 patients. On the basis of acute histologic lesion scores and the presence of donor-specific HLA antibodies, stable clustering was achieved on the basis of a consensus of 400 different clustering partitions. Additional information on kidney-transplant failure was introduced with a weighted Euclidean distance.ResultsBased on the proportion of ambiguous clustering, six clinically meaningful cluster phenotypes were identified. There was significant overlap with the existing Banff classification (adjusted rand index, 0.48). However, the data-driven approach eliminated intermediate and mixed phenotypes and created acute rejection clusters that are each significantly associated with graft failure. Finally, a novel visualization tool presents disease phenotypes and severity in a continuous manner, as a complement to the discrete clusters.ConclusionsA semisupervised clustering approach for the identification of clinically meaningful novel phenotypes of kidney transplant rejection has been developed and validated. The approach has the potential to offer a more quantitative evaluation of rejection subtypes and severity, especially in situations in which the current histologic categorization is ambiguous.

scholarly journals Survival after Kidney Transplantation during Childhood and Adolescence

2020 ◽  
Vol 15 (3) ◽  
pp. 392-400 ◽  
Author(s):  
Anna Francis ◽  
David W. Johnson ◽  
Anette Melk ◽  
Bethany J. Foster ◽  
Katrina Blazek ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Cox Regression ◽  
Survival Rates ◽  
Childhood And Adolescence ◽  
Kidney Transplant Recipients ◽  
Pediatric Kidney Transplantation ◽  
The Past ◽  
Specific Mortality ◽  
Transplant Registry

Background and objectivesSurvival in pediatric kidney transplant recipients has improved over the past five decades, but changes in cause-specific mortality remain uncertain. The aim of this retrospective cohort study was to estimate the associations between transplant era and overall and cause-specific mortality for child and adolescent recipients of kidney transplants.Design, setting, participants, & measurementsData were obtained on all children and adolescents (aged <20 years) who received their first kidney transplant from 1970 to 2015 from the Australian and New Zealand Dialysis and Transplant Registry. Mortality rates were compared across eras using Cox regression, adjusted for confounders.ResultsA total of 1810 recipients (median age at transplantation 14 years, 58% male, 52% living donor) were followed for a median of 13.4 years. Of these, 431 (24%) died, 174 (40%) from cardiovascular causes, 74 (17%) from infection, 50 (12%) from cancer, and 133 (31%) from other causes. Survival rates improved over time, with 5-year survival rising from 85% for those first transplanted in 1970–1985 (95% confidence interval [95% CI], 81% to 88%) to 99% in 2005–2015 (95% CI, 98% to 100%). This was primarily because of reductions in deaths from cardiovascular causes (adjusted hazard ratio [aHR], 0.25; 95% CI, 0.08 to 0.68) and infections (aHR, 0.16; 95% CI, 0.04 to 0.70; both for 2005–2015 compared with 1970–1985). Compared with patients transplanted 1970–1985, mortality risk was 72% lower among those transplanted 2005–2015 (aHR, 0.28; 95% CI, 0.18 to 0.69), after adjusting for potential confounders.ConclusionsSurvival after pediatric kidney transplantation has improved considerably over the past four decades, predominantly because of marked reductions in cardiovascular- and infection-related deaths.

Reproducibility of the Banff classification in subclinical kidney transplant rejection

2005 ◽  
Vol 19 (4) ◽  
pp. 518-521 ◽  
Author(s):  
Francisco Verissimo Veronese ◽  
Roberto Ceratti Manfro ◽  
Fernando Roberto Roman ◽  
Maria Isabel Edelweiss ◽  
David N Rush ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Transplant Rejection ◽  
Banff Classification
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