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52. The Banff 2007 working classification of skin-containing composite tissue allograft pathology.

Author

Cendales, L C, Kanitakis, Jean, Schneeberger, S, Burns, C, Ruiz Patino, Maria Jose, Landin, L, Remmelink, Myriam, Hewitt, C W, Landgren, T, Lyons, B, Drachenberg, C B, Solez, K, Kirk, A D, Kleiner, D E, Racusen, L, Cendales, L C, Kanitakis, Jean, Schneeberger, S, Burns, C, Ruiz Patino, Maria Jose, Landin, L, Remmelink, Myriam, Hewitt, C W, Landgren, T, Lyons, B, Drachenberg, C B, Solez, K, Kirk, A D, Kleiner, D E, and Racusen, L

Abstract

Composite tissue allotransplantation (CTA) is a recently introduced option for limb replacement and reconstruction of tissue defects. As with other allografts, CTA can undergo immune-mediated rejection; therefore standardized criteria are required for characterizing and reporting severity and types of rejection. This article documents the conclusions of a symposium on CTA rejection held at the Ninth Banff Conference on Allograft Pathology in La-Coruna, Spain, on 26 June 2007, and proposes a working classification, the Banff CTA-07, for the categorization of CTA rejection. This classification was derived from a consensus discussion session attended by the first authors of three published classification systems, pathologists and researchers from international centers where clinical CTA has been performed. It was open to all attendees to the Banff conference. To the extent possible, the format followed the established National Institutes of Health (NIH) guidelines on Consensus Development Programs. By consensus, the defining features to diagnose acute skin rejection include inflammatory cell infiltration with involvement of epidermis and/or adnexal structures, epithelial apoptosis, dyskeratosis and necrosis. Five grades of severity of rejection are defined. This classification refines proposed schemas, represents international consensus on this topic, and establishes a working collective classification system for CTA reporting of rejection in skin-containing CTAs., Consensus Development Conference, Journal Article, Research Support, N.I.H. Intramural, Research Support, Non-U.S. Gov't, SCOPUS: cp.j, FLWIN, info:eu-repo/semantics/published

Published
2008

53. Abstract 34

Author

Wang, Howard D, primary, Chou, HH, additional, Mohan, R, additional, Nam, AJ, additional, Magarakis, M, additional, Mundinger, GS, additional, Brown, EN, additional, Kelamis, JA, additional, Jones, LS, additional, Drachenberg, C, additional, Price, LA, additional, Christy, MR, additional, and Rodriguez, ED, additional

Published
2013
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62. Histological Evolution of BK Virus–Associated Nephropathy: Importance of Integrating Clinical and Pathological Findings

Author

Drachenberg, C. B., Papadimitriou, J. C., Chaudhry, M. R., Ugarte, R., Mavanur, M., Thomas, B., Cangro, C., Costa, N., Ramos, E., Weir, M. R., and Haririan, A.

Abstract

Long‐term clinicopathological studies of BK‐associated nephropathy (PyVAN) are not available. We studied 206 biopsies (71 patients), followed 3.09 ± 1.46 years after immunosuppression reduction. The biopsy features (% immunostain for PyV large T ag + staining and inflammation ± acute rejection) were correlated with viral load dynamics and serum creatinine to define the clinicopathological status (PyVCPS). Incidence of acute rejection was 28% in the second biopsy and 50% subsequently (25% mixed T cell–mediated allograft rejection (TCMR) + antibody‐mediated allograft rejection (AMR); rejection overall affected 38% of patients (>50% AMR). Graft loss was 15.4% (0.8–5.3 years after PyVAN); 76% had complete viral clearance (mean 28 weeks). The only predictors of graft loss were acute rejection (TCMRp = 0.008, any type p = 0.07), and increased “t” and “ci” in the second biopsy (p = 0.006 and 0.048). Higher peak viremia correlated with poorer viral clearance (p = 0.002). Presumptive and proven PyVANhad similar presentation, evolution, and outcome. Late PyVAN(>2 years, 9.8%) justifies BKviremia evaluation at any point with graft dysfunction and/or biopsy evaluation. This study describes the histological evolution of PyVANand corresponding clinicopathological correlations. Although the pathological features overall reflect the viral and immunological interactions, the PyVANcourse remains difficult to predict based on any single feature. Appropriate clinical management requires repeat biopsies and determination of the PyVCPSat relevant time points, for corresponding personalized immunosuppression adjustment. Histological evaluation of first and repeat renal biopsies in patients with BK virus–associated nephropathy, in combination with data on viral dynamics and graft function, shows the importance of incorporating clinical and biopsy findings for patient management. See Nankivell et al's article on page 2065, as well as Mengel's editorial on page 1972.

Published
2017
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66. CHRONIC REJECTION IN A NON-HUMAN PRIMATE MODEL OF FACIAL COMPOSITE TISSUE ALLOTRANSPLANTATION: CLINICAL, PATHOLOGICAL, AND IMMUNOHISTOCHEMICAL CHARACTERIZATION

Author

Mundinger, G. S., primary, Munivenkatappa, R., additional, Hui-Chou, H. G., additional, Drachenberg, C., additional, Shipley, S. T., additional, Jones, L. S., additional, Dorafshar, A., additional, Rodriguez, E. D., additional, Bartlett, S. T., additional, and Barth, R. N., additional

Published
2010
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68. A BANFF CV2 LESION IN A PRE-IMPLANTATION BIOPSY IS THE BEST PREDICTOR OF DELAYED GRAFT FUNCTION FOLLOWING RENAL TRANSPLANTATION.

Author

Munivenkatappa, R., primary, Malat, G., additional, Soundararajan, S., additional, Ranganna, K., additional, Drachenberg, C., additional, Papadimtriou, J. C., additional, Fayek, S. A., additional, Barth, R. N., additional, Cooper, M., additional, David, K., additional, Schweitzer, E. J., additional, Bartlett, S. T., additional, Kumar, M., additional, and Philosophe, B., additional

Published
2010
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69. VALIDATION OF THE MARYLAND AGGREGATE PATHOLOGY INDEX (MAPI) ON PRE-IMPLANTATION BIOPSIES (PIB) AS A PREDICTOR OF GRAFT OUTCOME AT TWO INDEPENDENT TRANSPLANT CENTERS.

Author

Munivenkatappa, R., primary, Drachenberg, C., additional, Papadimtriou, J. C., additional, Malat, G., additional, Soundararajan, S., additional, Ranganna, K., additional, Fayek, S., additional, Barth, R. N., additional, Wali, R., additional, Cooper, M., additional, Schweitzer, E. J., additional, Bartlett, S. T., additional, Kumar, M., additional, and Philosophe, B., additional

Published
2010
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71. THE BANFF 2007 WORKING CLASSIFICATION OF SKIN-CONTAINING COMPOSITE TISSUE ALLOGRAFT PATHOLOGY

Author

Cendales, L C., primary, Kanitakis, J, additional, Schneeberger, S, additional, Burns, C, additional, Ruiz, P, additional, Landin, L, additional, Remmelink, M, additional, Hewitt, C W., additional, Landgren, T, additional, Lyons, B, additional, Drachenberg, C B., additional, Solez, K, additional, Kirk, A D., additional, Kleiner, D E., additional, and Racusen, L, additional

Published
2008
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85. BK Polyomavirus Infection and Renourinary Tumorigenesis

Author

Papadimitriou, J. C., Randhawa, P., Rinaldo, C. Hanssen, Drachenberg, C. B., Alexiev, B., and Hirsch, H. H.

Abstract

BK polyomavirus (BKPyV) infection represents a major problem in transplantation, particularly for renal recipients developing polyomavirus‐associated nephropathy (PyVAN). The possibility that BKPyV may also be oncogenic is not routinely considered. Twenty high‐grade renourinary tumors expressing polyomavirus large T antigen in the entirety of the neoplasm in 19 cases, including the metastases in six, have been reported in transplant recipients with a history of PyVAN or evidence of BKPyV infection. Morphological and phenotypical features consistent with inactivation of the tumor suppressors pRB and p53 were found in the bladder tumors, suggesting a carcinogenesis mechanism involving the BKPyV large tumor oncoprotein/antigen. The pathogenesis of these tumors is unclear, but given the generally long interval between transplantation and tumor development, the risk for neoplasms after BKPyV infections may well be multifactorial. Other elements potentially implicated include exposure to additional exogenous carcinogens, further viral mutations, and cell genomic instability secondary to viral integration, as occurs with the Merkel cell PyV–associated carcinoma. The still scarce but increasingly reported association between longstanding PyVAN and renourinary neoplasms requires a concerted effort from the transplant community to better understand, diagnose, and treat the putative association between the BKPyV and these neoplasms.

Published
2016
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91. CMV ALLOGRAFT PANCREATITIS

Author

Klassen, D. K., primary, Drachenberg, C. B., additional, Papadimitriou, J. C., additional, Cangro, C. B., additional, Fink, J. C., additional, Bartlett, S. T., additional, and Weir, M. R., additional

Published
2000
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