Banff 2022 updated classification of renal allograft pathology.

IF 2.3 4区 医学 Q2 UROLOGY & NEPHROLOGY
Nephron Pub Date : 2025-06-07 DOI:10.1159/000546870
Tomokazu Shimizu, Toshihito Hirai, Kohei Unagam, Toshio Takagi, Hideki Ishida
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引用次数: 0

Abstract

Background The 16th Banff Meeting for Allograft Pathology was held in Banff, Canada from September 19 to 23, 2022. The results were published in the American Journal of Transplantation in March this year as "The Banff 2022 Kidney Meeting Report: Reappraisal of Microvascular Inflammation and the Role of Biopsy-based Transcript Diagnostics". Summary The changes in the Banff 2022 classification (Banff 2022) have four distinct features. The first was the modification of antibody-mediated rejection (AMR). The key points are microvascular inflammation/injury (MVI); the presence or absence of C4d deposition in the peritubular capillaries; and the presence or absence of donor-specific antibodies (DSA). Even if the MVI is above the threshold, if C4d and DSA are negative, it is not classified as AMR but as "MVI, DSA-negative, and C4d-negative". Furthermore, if MVI is below the threshold, C4d is negative but DSA is positive, the patient is classified under "probable AMR". Second, patients with acute tubular injury (ATI) without other obvious causes such as ischemia are excluded from AMR. Third, the Banff cv score for "arterial intimal fibrosis of new onset" (AIFNO) is excluded from AMR when used alone. Fourth, non-HLA antibodies, except for anti-blood group antibodies in ABO-incompatible kidney transplants, were excluded from DSA and included in the diagnostic criteria for AMR. Key Massages The changes in Banff 2022 are as follows, implementation of new terminology, such as MVI, DSA-negative, and C4d-negative and probable AMR, ATI and AIFNO are excluded from AMR, and non-HLA antibodies are excluded from DSA.

Banff 2022更新了同种异体肾移植病理分类。
第16届同种异体移植物病理学班夫会议于2022年9月19日至23日在加拿大班夫举行。该研究结果发表在今年3月的《美国移植杂志》上,题为“班夫2022肾脏会议报告:微血管炎症的重新评估和基于活检的转录本诊断的作用”。班夫2022分类(Banff 2022)的变化有四个明显的特点。首先是抗体介导的排斥反应(AMR)的修饰。重点是微血管炎症/损伤(MVI);小管周围毛细血管中是否存在C4d沉积;以及是否存在供体特异性抗体(DSA)。即使MVI高于阈值,如果C4d和DSA均为阴性,则不归类为AMR,而是“MVI、DSA阴性、C4d阴性”。如果MVI低于阈值,C4d阴性,DSA阳性,则归为“可能AMR”。其次,无其他明显原因如缺血等的急性小管损伤(ATI)患者被排除在AMR之外。第三,单独使用AMR时,“新发动脉内膜纤维化”(AIFNO)的Banff cv评分被排除在AMR之外。第四,除abo血型不相容肾移植的抗血型抗体外,将非hla抗体排除在DSA之外,纳入AMR的诊断标准。Banff 2022的变化如下,实施了新的术语,如MVI, DSA阴性,c4d阴性和可能的AMR, ATI和AIFNO从AMR中排除,非hla抗体从DSA中排除。
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来源期刊
Nephron
Nephron UROLOGY & NEPHROLOGY-
CiteScore
5.00
自引率
0.00%
发文量
80
期刊介绍: ''Nephron'' comprises three sections, which are each under the editorship of internationally recognized leaders and served by specialized Associate Editors. Apart from high-quality original research, ''Nephron'' publishes invited reviews/minireviews on up-to-date topics. Papers undergo an innovative and transparent peer review process encompassing a Presentation Report which assesses and summarizes the presentation of the paper in an unbiased and standardized way.
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