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Thrombotic Microangiopathy in the Renal Allograft: Results of the TMA Banff Working Group Consensus on Pathologic Diagnostic Criteria
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...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10481335/ https://www.ncbi.nlm.nih.gov/pubmed/37680648 http://dx.doi.org/10.3389/ti.2023.11590 |
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author | Afrouzian, Marjan Kozakowski, Nicolas Liapis, Helen Broecker, Verena Truong, Luon Avila-Casado, Carmen Regele, Heinz Seshan, Surya Ambruzs, Josephine M. Farris, Alton Brad Buob, David Chander, Praveen N. Cheraghvandi, Lukman Clahsen-van Groningen, Marian C. de Almeida Araujo, Stanley Ertoy Baydar, Dilek Formby, Mark Galesic Ljubanovic, Danica Herrera Hernandez, Loren Honsova, Eva Mohamed, Nasreen Ozluk, Yasemin Rabant, Marion Royal, Virginie Stevenson, Heather L. Toniolo, Maria Fernanda Taheri, Diana |
author_facet | Afrouzian, Marjan Kozakowski, Nicolas Liapis, Helen Broecker, Verena Truong, Luon Avila-Casado, Carmen Regele, Heinz Seshan, Surya Ambruzs, Josephine M. Farris, Alton Brad Buob, David Chander, Praveen N. Cheraghvandi, Lukman Clahsen-van Groningen, Marian C. de Almeida Araujo, Stanley Ertoy Baydar, Dilek Formby, Mark Galesic Ljubanovic, Danica Herrera Hernandez, Loren Honsova, Eva Mohamed, Nasreen Ozluk, Yasemin Rabant, Marion Royal, Virginie Stevenson, Heather L. Toniolo, Maria Fernanda Taheri, Diana |
author_sort | Afrouzian, Marjan |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-10481335 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-104813352023-09-07 Thrombotic Microangiopathy in the Renal Allograft: Results of the TMA Banff Working Group Consensus on Pathologic Diagnostic Criteria Afrouzian, Marjan Kozakowski, Nicolas Liapis, Helen Broecker, Verena Truong, Luon Avila-Casado, Carmen Regele, Heinz Seshan, Surya Ambruzs, Josephine M. Farris, Alton Brad Buob, David Chander, Praveen N. Cheraghvandi, Lukman Clahsen-van Groningen, Marian C. de Almeida Araujo, Stanley Ertoy Baydar, Dilek Formby, Mark Galesic Ljubanovic, Danica Herrera Hernandez, Loren Honsova, Eva Mohamed, Nasreen Ozluk, Yasemin Rabant, Marion Royal, Virginie Stevenson, Heather L. Toniolo, Maria Fernanda Taheri, Diana Transpl Int Health Archive 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. Frontiers Media S.A. 2023-08-23 /pmc/articles/PMC10481335/ /pubmed/37680648 http://dx.doi.org/10.3389/ti.2023.11590 Text en 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. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Health Archive Afrouzian, Marjan Kozakowski, Nicolas Liapis, Helen Broecker, Verena Truong, Luon Avila-Casado, Carmen Regele, Heinz Seshan, Surya Ambruzs, Josephine M. Farris, Alton Brad Buob, David Chander, Praveen N. Cheraghvandi, Lukman Clahsen-van Groningen, Marian C. de Almeida Araujo, Stanley Ertoy Baydar, Dilek Formby, Mark Galesic Ljubanovic, Danica Herrera Hernandez, Loren Honsova, Eva Mohamed, Nasreen Ozluk, Yasemin Rabant, Marion Royal, Virginie Stevenson, Heather L. Toniolo, Maria Fernanda Taheri, Diana Thrombotic Microangiopathy in the Renal Allograft: Results of the TMA Banff Working Group Consensus on Pathologic Diagnostic Criteria |
title | Thrombotic Microangiopathy in the Renal Allograft: Results of the TMA Banff Working Group Consensus on Pathologic Diagnostic Criteria |
title_full | Thrombotic Microangiopathy in the Renal Allograft: Results of the TMA Banff Working Group Consensus on Pathologic Diagnostic Criteria |
title_fullStr | Thrombotic Microangiopathy in the Renal Allograft: Results of the TMA Banff Working Group Consensus on Pathologic Diagnostic Criteria |
title_full_unstemmed | Thrombotic Microangiopathy in the Renal Allograft: Results of the TMA Banff Working Group Consensus on Pathologic Diagnostic Criteria |
title_short | Thrombotic Microangiopathy in the Renal Allograft: Results of the TMA Banff Working Group Consensus on Pathologic Diagnostic Criteria |
title_sort | thrombotic microangiopathy in the renal allograft: results of the tma banff working group consensus on pathologic diagnostic criteria |
topic | Health Archive |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10481335/ https://www.ncbi.nlm.nih.gov/pubmed/37680648 http://dx.doi.org/10.3389/ti.2023.11590 |
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