INTERNATIONAL STANDARDIZATION OF CRITERIA FOR THE HISTOLOGIC DIAGNOSIS OF RENAL-ALLOGRAFT REJECTION - THE BANFF WORKING CLASSIFICATION OF KIDNEY-TRANSPLANT PATHOLOGY
INTERNATIONAL STANDARDIZATION OF CRITERIA FOR THE HISTOLOGIC DIAGNOSIS OF RENAL-ALLOGRAFT REJECTION - THE BANFF WORKING CLASSIFICATION OF KIDNEY-TRANSPLANT PATHOLOGY
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DOI：
10.1038/ki.1993.259
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发表时间：
1993-08-01
影响因子：
19.6
通讯作者：
YAMAGUCHI, Y
中科院分区：
文献类型：
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作者：
SOLEZ, K;AXELSEN, RA;YAMAGUCHI, Y
1991年8月2日至4日，一组肾脏病理学家、肾病学家和移植外科医生在加拿大班夫开会，制定肾移植排斥反应组织学诊断的命名和标准的国际标准化方案。会议结束后继续开发，并通过参与病理学家评分的幻灯片集的循环验证了该方案。在这种情况下，动脉内膜炎和小管炎是急性排斥反应的主要病变。急性排斥和“慢性排斥”的肾小球、间质、肾小管和血管病变被定义并评分为0至3+，以产生每次活检的急性和/或慢性数字编码。还对小动脉透明变性（环孢霉素毒性的指征）进行评分。主要的诊断类别，可以使用或不使用定量编码，是：（1）正常，（2）超急性排斥反应，（3）临界变化，（4）急性排斥反应（I至III级），（5）慢性移植物肾病（“慢性排斥”）（I至III级），和（6）其他。我们的目标是设计一个方案，其中给定的活检分级将意味着治疗反应或长期功能的预后。虽然临床意义必须通过进一步的研究来证明，但标准化模式的发展是关键的第一步。这种标准化的分类应该促进移植肾病理报告的国际统一性，促进肾移植新疗法的多中心试验的实施，并最终改善肾移植受者的管理和护理。
A group of renal pathologists, nephrologists, and transplant surgeons met in Banff, Canada on August 2-4, 1991 to develop a schema for international standardization of nomenclature and criteria for the histologic diagnosis of renal allograft rejection. Development continued after the meeting and the schema was validated by the circulation of sets of slides for scoring by participant pathologists. In this schema intimal arteritis and tubulitis are the principal lesions indicative of acute rejection. Glomerular, interstitial, tubular, and vascular lesions of acute rejection and ''chronic rejection'' are defined and scored 0 to 3+, to produce an acute and/or chronic numerical coding for each biopsy. Arteriolar hyalinosis (an indication of cyclosporine toxicity) is also scored. Principal diagnostic categories, which can be used with or without the quantitative coding, are: (1) normal, (2) hyperacute rejection, (3) borderline changes, (4) acute rejection (grade I to III), (5) chronic allograft nephropathy (''chronic rejection'') (grade I to III), and (6) other. The goal is to devise a schema in which a given biopsy grading would imply a prognosis for a therapeutic response or long-term function. While the clinical implications must be proven through further studies, the development of a standardized schema is a critical first step. This standardized classification should promote international uniformity in reporting of renal allograft pathology, facilitate the performance of multicenter trials of new therapies in renal transplantation, and ultimately lead to improvement in the management and care of renal transplant recipients.