23 June 2015 : Original article
Reclassification of C4d-Positive Endomyocardial Biopsy (EMB) According to New International Society for Heart and Lung Transplantation (ISHLT) 2013 Categories for Reporting Pathologic Antibody-Mediated Rejection (pAMR): Preliminary Data from a Polish Single-Center Study
Sylwia SzymańskaADE, Wiesława GrajkowskaADE, Małgorzata Sobieszczańska-MałekABE, Tomasz ZielińskiABE, Maciej PronickiADEDOI: 10.12659/AOT.893635
Ann Transplant 2015; 20:351-356
Abstract
BACKGROUND: The International Society for Heart and Lung Transplantation (ISHLT) has recently proposed a new protocol for reporting pathologic diagnosis of antibody-mediated rejection (pAMR). The new criteria precisely defined antibody panels and morphologic features indicative of AMR. The aim of this study was to reclassify endomyocardial biopsy specimens (EMBs) that had previously been classified as C4d-positive (AMR1) according to the former ISHLT 2004 protocol and to verify whether the new, stricter criteria have any impact on number of AMR diagnosis.
MATERIAL AND METHODS: We retrospectively analyzed 1374 EMBs from 212 patients who underwent heart transplantation in the years 2001–2013 and who were diagnosed at the Department of Pathology, The Children’s Memorial Health Institute. Recorded data were: histopathologic features indicative of AMR (endothelial swelling, interstitial edema, intracapillary macrophages and leucocytes); C4d stain patterns, and presence of cellular rejection (ACR) or Quilty effect in any biopsy. All EMBs were reevaluated according to new ISHLT 2013 criteria and pAMR was specified.
RESULTS: There were 77 EMBs from 46 (21.69%) patients that were initially diagnosed as AMR1 based on any C4d-positive stain. After reclassification according to ISHLT 2013: 22 (28.57%) EMBs were evaluated as pAMR 1(H+); 14 (18.18%) EMBs were pAMR 1(I+); 13 (16.88%) EMBs were pAMR 2, and 28 (36.36%) EMBs were pAMR0. Endothelial swelling was observed in 45 (58.44%) EMBs; interstitial edema in 32 (41.55%) EMBs, and intracapillary activated mononuclear cells in 26 (33.77%) EMBs. Then, all 1374 EMBs from 212 patients were reclassified and we noticed that pAMR1H+ was found in 95 (44.81%) patients; pAMR1I+ in 12 (5.66%) patients; pAMR2 in 8 (3.77%) patients; pAMR0 in 95 (45.75%) in patients, and pAMR3 was not present.
CONCLUSIONS: New, more restrictive ISHLT 2013 criteria for reporting pathologic antibody-mediated rejection (pAMR) decrease number of AMR diagnosis in a selected Polish population, but they increase number of silent/sub-silent AMR diagnoses.
Keywords: Biopsy, Graft Rejection, Heart Transplantation, Pathology
SARS-CoV-2/COVID-19
17 June 2022 : Case report
Extrapulmonary Manifestations of SARS-CoV-2: A Report of 3 Cases and a Literature ReviewAnn Transplant In Press; DOI: 10.12659/AOT.935874
12 April 2022 : Letter/Correspondence
Pancreas Allograft Thrombosis as a Post-COVID-19 Complication in a Diabetic Patient After Pancreas Transpla...Ann Transplant 2022; 27:e935863
12 November 2021 : Original article
Coronavirus Disease 2019 (COVID-19) in Solid Organ Transplant Recipients: A Case-Control StudyAnn Transplant 2021; 26:e933152
26 October 2021 : Original article
Safety of Antithymocyte Globulin Use in Kidney Graft Recipients During the COVID-19 PandemicAnn Transplant 2021; 26:e933001
In Press
23 Jun 2022 : Original article
Evaluation of Deceased Donor Kidney Transplantation in the Eurotransplant Senior Program in Comparison to S...Ann Transplant In Press; DOI: 10.12659/AOT.936514
21 Jun 2022 : Case report
Extrapulmonary Manifestations of SARS-CoV-2: A Report of 3 Cases and a Literature ReviewAnn Transplant In Press; DOI: 10.12659/AOT.935874
20 Jun 2022 : Original article
The Association Between Tacrolimus Levels and Hyperkalemia in Allograft Recipients Who Underwent Heart or L...Ann Transplant In Press; DOI: 10.12659/AOT.935607
15 Jun 2022 : Original article
Donor CYP3A5 Expression Decreases Renal Transplantation Outcomes in White Renal Transplant RecipientsAnn Transplant In Press; DOI: 10.12659/AOT.936276
Most Viewed Current Articles
26 Jan 2022 : Review article
Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive ModelsDOI :10.12659/AOT.934924
Ann Transplant 2022; 27:e934924
29 Dec 2021 : Original article
Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...DOI :10.12659/AOT.933588
Ann Transplant 2021; 26:e933588
24 Jul 2020 : Review article
Kidney Transplantation in the Times of COVID-19 – A Literature ReviewDOI :10.12659/AOT.925755
Ann Transplant 2020; 25:e925755
15 Mar 2022 : Case report
Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...DOI :10.12659/AOT.935860
Ann Transplant 2022; 27:e935860