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Re‐evaluation of glomerulitis using occlusion criteria based on the Banff 2013 revision: a retrospective study

The presence of occlusion/near‐occlusion of glomerular capillaries was recently added to the existing definition of glomerulitis (g). We retrospectively re‐evaluated 135 renal allograft biopsies regarding g to ensure no antibody‐damaged grafts were missed. Previous and revised g scores (pg and rg, r... Full description

Journal Title: Transplant International June 2017, Vol.30(6), pp.579-588
Main Author: Ozluk, Yasemin
Other Authors: Caliskan, Yasar , Sevinc, Mustafa , Bayram, Aysel , Arikan, Evsen A. , Turkmen, Aydin , Akgul, Sebahat , Savran, Fatma O. , Sever, Mehmet S. , Kilicaslan, Isin
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ID: ISSN: 0934-0874 ; E-ISSN: 1432-2277 ; DOI: 10.1111/tri.12943
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title: Re‐evaluation of glomerulitis using occlusion criteria based on the Banff 2013 revision: a retrospective study
format: Article
creator:
  • Ozluk, Yasemin
  • Caliskan, Yasar
  • Sevinc, Mustafa
  • Bayram, Aysel
  • Arikan, Evsen A.
  • Turkmen, Aydin
  • Akgul, Sebahat
  • Savran, Fatma O.
  • Sever, Mehmet S.
  • Kilicaslan, Isin
subjects:
  • Banff Classification
  • Biopsy
  • Glomerulitis
  • Renal Transplant
ispartof: Transplant International, June 2017, Vol.30(6), pp.579-588
description: The presence of occlusion/near‐occlusion of glomerular capillaries was recently added to the existing definition of glomerulitis (g). We retrospectively re‐evaluated 135 renal allograft biopsies regarding g to ensure no antibody‐damaged grafts were missed. Previous and revised g scores (pg and rg, respectively) were compared for clinicopathologic correlations. The g score did not change in 100 (74.1%) biopsies. Thirty‐five (25.9%) biopsies were changed to a lower score. Sensitivity and specificity of pg and rg for the presence of donor‐specific antibodies () were 76% vs. 58% and 70% vs. 79%, respectively. Pg score indicated graft loss with 65% sensitivity and 63% specificity, whereas rg showed 46% sensitivity and 71% specificity. Area under the curve () values in analysis for and graft loss were as follows: pg, 0.773; rg, 0.693; and pg, 0.635; rg, 0.577, respectively. A comparison of the two values revealed a significant difference between pg and rg only for ( = 0.0076). Pg and post‐transplant time of biopsy independently predicted graft loss, whereas rg did not. In conclusion, revised g scores showed lesser sensitivity but higher specificity for and graft loss. Recent definition of g missed antibody‐mediated rejection in few cases, and it was not an independent predictor for graft loss.
language:
source:
identifier: ISSN: 0934-0874 ; E-ISSN: 1432-2277 ; DOI: 10.1111/tri.12943
fulltext: fulltext
issn:
  • 0934-0874
  • 09340874
  • 1432-2277
  • 14322277
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titleRe‐evaluation of glomerulitis using occlusion criteria based on the Banff 2013 revision: a retrospective study
creatorOzluk, Yasemin ; Caliskan, Yasar ; Sevinc, Mustafa ; Bayram, Aysel ; Arikan, Evsen A. ; Turkmen, Aydin ; Akgul, Sebahat ; Savran, Fatma O. ; Sever, Mehmet S. ; Kilicaslan, Isin
ispartofTransplant International, June 2017, Vol.30(6), pp.579-588
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subjectBanff Classification ; Biopsy ; Glomerulitis ; Renal Transplant
descriptionThe presence of occlusion/near‐occlusion of glomerular capillaries was recently added to the existing definition of glomerulitis (g). We retrospectively re‐evaluated 135 renal allograft biopsies regarding g to ensure no antibody‐damaged grafts were missed. Previous and revised g scores (pg and rg, respectively) were compared for clinicopathologic correlations. The g score did not change in 100 (74.1%) biopsies. Thirty‐five (25.9%) biopsies were changed to a lower score. Sensitivity and specificity of pg and rg for the presence of donor‐specific antibodies () were 76% vs. 58% and 70% vs. 79%, respectively. Pg score indicated graft loss with 65% sensitivity and 63% specificity, whereas rg showed 46% sensitivity and 71% specificity. Area under the curve () values in analysis for and graft loss were as follows: pg, 0.773; rg, 0.693; and pg, 0.635; rg, 0.577, respectively. A comparison of the two values revealed a significant difference between pg and rg only for ( = 0.0076). Pg and post‐transplant time of biopsy independently predicted graft loss, whereas rg did not. In conclusion, revised g scores showed lesser sensitivity but higher specificity for and graft loss. Recent definition of g missed antibody‐mediated rejection in few cases, and it was not an independent predictor for graft loss.
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titleRe‐evaluation of glomerulitis using occlusion criteria based on the Banff 2013 revision: a retrospective study
descriptionThe presence of occlusion/near‐occlusion of glomerular capillaries was recently added to the existing definition of glomerulitis (g). We retrospectively re‐evaluated 135 renal allograft biopsies regarding g to ensure no antibody‐damaged grafts were missed. Previous and revised g scores (pg and rg, respectively) were compared for clinicopathologic correlations. The g score did not change in 100 (74.1%) biopsies. Thirty‐five (25.9%) biopsies were changed to a lower score. Sensitivity and specificity of pg and rg for the presence of donor‐specific antibodies () were 76% vs. 58% and 70% vs. 79%, respectively. Pg score indicated graft loss with 65% sensitivity and 63% specificity, whereas rg showed 46% sensitivity and 71% specificity. Area under the curve () values in analysis for and graft loss were as follows: pg, 0.773; rg, 0.693; and pg, 0.635; rg, 0.577, respectively. A comparison of the two values revealed a significant difference between pg and rg only for ( = 0.0076). Pg and post‐transplant time of biopsy independently predicted graft loss, whereas rg did not. In conclusion, revised g scores showed lesser sensitivity but higher specificity for and graft loss. Recent definition of g missed antibody‐mediated rejection in few cases, and it was not an independent predictor for graft loss.
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titleRe‐evaluation of glomerulitis using occlusion criteria based on the Banff 2013 revision: a retrospective study
authorOzluk, Yasemin ; Caliskan, Yasar ; Sevinc, Mustafa ; Bayram, Aysel ; Arikan, Evsen A. ; Turkmen, Aydin ; Akgul, Sebahat ; Savran, Fatma O. ; Sever, Mehmet S. ; Kilicaslan, Isin
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abstractThe presence of occlusion/near‐occlusion of glomerular capillaries was recently added to the existing definition of glomerulitis (g). We retrospectively re‐evaluated 135 renal allograft biopsies regarding g to ensure no antibody‐damaged grafts were missed. Previous and revised g scores (pg and rg, respectively) were compared for clinicopathologic correlations. The g score did not change in 100 (74.1%) biopsies. Thirty‐five (25.9%) biopsies were changed to a lower score. Sensitivity and specificity of pg and rg for the presence of donor‐specific antibodies () were 76% vs. 58% and 70% vs. 79%, respectively. Pg score indicated graft loss with 65% sensitivity and 63% specificity, whereas rg showed 46% sensitivity and 71% specificity. Area under the curve () values in analysis for and graft loss were as follows: pg, 0.773; rg, 0.693; and pg, 0.635; rg, 0.577, respectively. A comparison of the two values revealed a significant difference between pg and rg only for ( = 0.0076). Pg and post‐transplant time of biopsy independently predicted graft loss, whereas rg did not. In conclusion, revised g scores showed lesser sensitivity but higher specificity for and graft loss. Recent definition of g missed antibody‐mediated rejection in few cases, and it was not an independent predictor for graft loss.
doi10.1111/tri.12943
pages579-588
orcidid0000-0002-7191-0488
date2017-06