TY - JOUR
T1 - Thrombotic Microangiopathy in the Renal Allograft
T2 - Results of the TMA Banff Working Group Consensus on Pathologic Diagnostic Criteria
AU - Afrouzian, Marjan
AU - Kozakowski, Nicolas
AU - Liapis, Helen
AU - Broecker, Verena
AU - Truong, Luon
AU - Avila-Casado, Carmen
AU - Regele, Heinz
AU - Seshan, Surya
AU - Ambruzs, Josephine M.
AU - Farris, Alton Brad
AU - Buob, David
AU - Chander, Praveen N.
AU - Cheraghvandi, Lukman
AU - Clahsen-van Groningen, Marian C.
AU - de Almeida Araujo, Stanley
AU - Ertoy Baydar, Dilek
AU - Formby, Mark
AU - Galesic Ljubanovic, Danica
AU - Herrera Hernandez, Loren
AU - Honsova, Eva
AU - Mohamed, Nasreen
AU - Ozluk, Yasemin
AU - Rabant, Marion
AU - Royal, Virginie
AU - Stevenson, Heather L.
AU - Toniolo, Maria Fernanda
AU - Taheri, Diana
N1 - Funding Information:
This study was performed under the auspices of the Banff Foundation on Allograft Pathology and supported by grants from the Banff Foundation (for publication fees) and Alexion Pharmaceuticals (#100288). The funders were not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication.
Publisher Copyright:
Copyright © 2023 Afrouzian, Kozakowski, Liapis, Broecker, Truong, Avila-Casado, Regele, Seshan, Ambruzs, Farris, Buob, Chander, Cheraghvandi, Clahsen-van Groningen, de Almeida Araujo, Ertoy Baydar, Formby, Galesic Ljubanovic, Herrera Hernandez, Honsova, Mohamed, Ozluk, Rabant, Royal, Stevenson, Toniolo and Taheri.
PY - 2023/8/23
Y1 - 2023/8/23
N2 - The Banff community summoned the TMA Banff Working Group to develop minimum diagnostic criteria (MDC) and recommendations for renal transplant TMA (Tx-TMA) diagnosis, which currently lacks standardized criteria. Using the Delphi method for consensus generation, 23 nephropathologists (panelists) with >3 years of diagnostic experience with Tx-TMA were asked to list light, immunofluorescence, and electron microscopic, clinical and laboratory criteria and differential diagnoses for Tx-TMA. Delphi was modified to include 2 validations rounds with histological evaluation of whole slide images of 37 transplant biopsies (28 TMA and 9 non-TMA). Starting with 338 criteria in R1, MDC were narrowed down to 24 in R8 generating 18 pathological, 2 clinical, 4 laboratory criteria, and 8 differential diagnoses. The panelists reached a good level of agreement (70%) on 76% of the validated cases. For the first time in Banff classification, Delphi was used to reach consensus on MDC for Tx-TMA. Phase I of the study (pathology phase) will be used as a model for Phase II (nephrology phase) for consensus regarding clinical and laboratory criteria. Eventually in Phase III (consensus of the consensus groups) and the final MDC for Tx-TMA will be reported to the transplantation community.
AB - The Banff community summoned the TMA Banff Working Group to develop minimum diagnostic criteria (MDC) and recommendations for renal transplant TMA (Tx-TMA) diagnosis, which currently lacks standardized criteria. Using the Delphi method for consensus generation, 23 nephropathologists (panelists) with >3 years of diagnostic experience with Tx-TMA were asked to list light, immunofluorescence, and electron microscopic, clinical and laboratory criteria and differential diagnoses for Tx-TMA. Delphi was modified to include 2 validations rounds with histological evaluation of whole slide images of 37 transplant biopsies (28 TMA and 9 non-TMA). Starting with 338 criteria in R1, MDC were narrowed down to 24 in R8 generating 18 pathological, 2 clinical, 4 laboratory criteria, and 8 differential diagnoses. The panelists reached a good level of agreement (70%) on 76% of the validated cases. For the first time in Banff classification, Delphi was used to reach consensus on MDC for Tx-TMA. Phase I of the study (pathology phase) will be used as a model for Phase II (nephrology phase) for consensus regarding clinical and laboratory criteria. Eventually in Phase III (consensus of the consensus groups) and the final MDC for Tx-TMA will be reported to the transplantation community.
UR - http://www.scopus.com/inward/record.url?scp=85169883444&partnerID=8YFLogxK
U2 - 10.3389/ti.2023.11590
DO - 10.3389/ti.2023.11590
M3 - Article
C2 - 37680648
AN - SCOPUS:85169883444
SN - 0934-0874
VL - 36
JO - Transplant International
JF - Transplant International
M1 - 11590
ER -