Preka, E;
Garcia, SCL;
Kim, JJ;
Kessaris, N;
Stojanovic, J;
Mamode, N;
Sebire, NJ;
... Marks, SD; + view all
(2018)
Improved Diagnosis and Management of Paediatric Renal Transplant Recipients Using the Banff 2013 Histopathological Classification.
Presented at: 27th International Congress of the Transplantation Society (TTS), Madrid, Spain.
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Abstract
Introduction: Since the publication of the 2013 Banff classification, adult studies have shown evidence of improved prognosis using the new histopathological criteria. Our study assesses for the first time the impact of the new classification on the diagnosis of acute antibody-mediated rejection (AMR) in paediatric renal transplant recipients (pRTR). / Methods: This single-centre study is a retrospective evaluation of 56 paediatric post-transplant de novo DSA-positive patients who had a percutaneous renal transplant biopsy due to renal allograft dysfunction from January 2006 to March 2012. Their biopsies were re-scored by a solitary specialist trained in 2013 Banff classification. The results were compared with previous classification as per 2003/2007 Banff criteria with results presented as range (median). / Results: At the time of biopsy, pRTR were aged 1.6 - 17.5 (median 14.9) years old with 412 - 2735 mean fluorescence intensity (MFI; maximal at 713 - 31,625; median 3466 and 4809). Following the 2013 Banff classification, there was a total of 5 cases of acute AMR compared to one confirmed and one suspicious AMR with the 2003/2007 Banff classification (with no change in the remaining 51 patients’ classification). Consequently, 5.3% (3 of 56) patients would have been diagnosed with T-cell mediated rejection with suboptimal treatment. There was an overall 70% (48 - 112%) decrease in the renal allograft function in the 6 months follow-up period after aggressive treatment for acute AMR and 2 of 3 patients had further rejection episodes in the following year. / Conclusion: This research supports the new Banff 2013 classification as a more precise classification in pRTR in the diagnosis of AMR with 5% of patients being correctly diagnosed and managed with improvement in renal allograft function.
| Type: | Conference item (Presentation) |
|---|---|
| Title: | Improved Diagnosis and Management of Paediatric Renal Transplant Recipients Using the Banff 2013 Histopathological Classification |
| Event: | 27th International Congress of the Transplantation Society (TTS) |
| Location: | Madrid, Spain |
| Dates: | 30 June - 05 July 2018 |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/01.tp.0000543290.92732.65 |
| Publisher version: | https://doi.org/10.1097/01.tp.0000543290.92732.65 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10064355 |
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