Banff 2022 pancreas transplantation multidisciplinary report: Refinement of guidelines for T cell–mediated rejection, antibody-mediated rejection and islet pathology. Assessment of duodenal cuff biopsies and noninvasive diagnostic methods
The Banff pancreas working schema for diagnosis and grading of rejection is widely used for treatment guidance and risk stratification in centers that perform pancreas allograft biopsies. Since the last update, various studies have provided additional insight regarding the application of the schema...
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Published in | American journal of transplantation Vol. 24; no. 3; pp. 362 - 379 |
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Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
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United States
Elsevier Inc
01.03.2024
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Abstract | The Banff pancreas working schema for diagnosis and grading of rejection is widely used for treatment guidance and risk stratification in centers that perform pancreas allograft biopsies. Since the last update, various studies have provided additional insight regarding the application of the schema and enhanced our understanding of additional clinicopathologic entities. This update aims to clarify terminology and lesion description for T cell–mediated and antibody-mediated allograft rejections, in both active and chronic forms. In addition, morphologic and immunohistochemical tools are described to help distinguish rejection from nonrejection pathologies. For the first time, a clinicopathologic approach to islet pathology in the early and late posttransplant periods is discussed. This update also includes a discussion and recommendations on the utilization of endoscopic duodenal donor cuff biopsies as surrogates for pancreas biopsies in various clinical settings. Finally, an analysis and recommendations on the use of donor-derived cell-free DNA for monitoring pancreas graft recipients are provided. This multidisciplinary effort assesses the current role of pancreas allograft biopsies and offers practical guidelines that can be helpful to pancreas transplant practitioners as well as experienced pathologists and pathologists in training. |
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AbstractList | The Banff pancreas working schema for diagnosis and grading of rejection is widely used for treatment guidance and risk stratification in centers that perform pancreas allograft biopsies. Since the last update, various studies have provided additional insight regarding the application of the schema and enhanced our understanding of additional clinicopathologic entities. This update aims to clarify terminology and lesion description for T cell–mediated and antibody-mediated allograft rejections, in both active and chronic forms. In addition, morphologic and immunohistochemical tools are described to help distinguish rejection from nonrejection pathologies. For the first time, a clinicopathologic approach to islet pathology in the early and late posttransplant periods is discussed. This update also includes a discussion and recommendations on the utilization of endoscopic duodenal donor cuff biopsies as surrogates for pancreas biopsies in various clinical settings. Finally, an analysis and recommendations on the use of donor-derived cell-free DNA for monitoring pancreas graft recipients are provided. This multidisciplinary effort assesses the current role of pancreas allograft biopsies and offers practical guidelines that can be helpful to pancreas transplant practitioners as well as experienced pathologists and pathologists in training. |
Author | Uva, Pablo Zhang, Lizhi Burke, George Merino-Torres, Juan Francisco Papadimitriou, John C. Cantarovich, Diego Rao, Joseph Sushil Cooper, Matthew Drachenberg, Cinthia B. Gruessner, Angelika Kudva, Yogish C. Stratta, Robert Vistoli, Fabio Buettner-Herold, Maike Arend, Lois Odorico, Jon Renaudin, Karine Aguiar, Pedro Ventura Toniolo, Maria Fernanda Horsfield, Catherine Ugarte, Richard Roufousse, Candice Kandaswamy, Raja Perosa, Marcelo Farris, Alton B. Dunn, Ty Parajuli, Sandesh White, Steven Rickels, Michael Haririan, Abdolreza Boggi, Ugo Grzyb, Krzyztof Meier, Raphael Parsons, Ronald F. Cuatrecasas, Miriam Mikhailov, Alexei V. Kukla, Aleksandra Argente-Pla, Maria Seshan, Surya V. Gruessner, Rainer |
Author_xml | – sequence: 1 givenname: Cinthia B. orcidid: 0000-0002-3104-5661 surname: Drachenberg fullname: Drachenberg, Cinthia B. email: cdrachenberg@som.umaryland.edu organization: Department of Pathology, University of Maryland School of Medicine, Maryland, USA – sequence: 2 givenname: Maike orcidid: 0000-0002-9974-6683 surname: Buettner-Herold fullname: Buettner-Herold, Maike organization: Department of Nephropathology, Institute of Pathology, Friedrich-Alexander-University Erlangen-Nuremberg (FAU) and University Hospital, Erlangen, Germany – sequence: 3 givenname: Pedro Ventura orcidid: 0000-0003-3381-7503 surname: Aguiar fullname: Aguiar, Pedro Ventura organization: Department of Nephrology, Hospital Clìnic de Barcelona, Barcelona, Spain – sequence: 4 givenname: Catherine orcidid: 0000-0002-6103-5149 surname: Horsfield fullname: Horsfield, Catherine organization: Department of Histopathology/Cytology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom – sequence: 5 givenname: Alexei V. orcidid: 0000-0002-5695-129X surname: Mikhailov fullname: Mikhailov, Alexei V. organization: Department of Pathology, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina, USA – sequence: 6 givenname: John C. orcidid: 0000-0001-7963-5380 surname: Papadimitriou fullname: Papadimitriou, John C. organization: Department of Pathology, University of Maryland School of Medicine, Maryland, USA – sequence: 7 givenname: Surya V. orcidid: 0000-0003-4384-0694 surname: Seshan fullname: Seshan, Surya V. organization: Division of Renal Pathology, Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, Cornell University, New York, New York, USA – sequence: 8 givenname: Marcelo orcidid: 0000-0002-8576-9761 surname: Perosa fullname: Perosa, Marcelo organization: Beneficência Portuguesa and Bandeirantes Hospital of São Paulo, São Paulo, Brazil – sequence: 9 givenname: Ugo orcidid: 0000-0002-7505-5896 surname: Boggi fullname: Boggi, Ugo organization: Department of Surgery, University of Pisa, Pisa, The province of Pisa, Italy – sequence: 10 givenname: Pablo orcidid: 0000-0001-7317-3875 surname: Uva fullname: Uva, Pablo organization: Kidney/Pancreas Transplant Program, Instituto de Trasplantes y Alta Complejidad (ITAC – Nephrology), Buenos Aires, Argentina – sequence: 11 givenname: Michael orcidid: 0000-0002-9253-838X surname: Rickels fullname: Rickels, Michael organization: Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Philadelphia, USA – sequence: 12 givenname: Krzyztof orcidid: 0000-0002-2718-8125 surname: Grzyb fullname: Grzyb, Krzyztof organization: Department of Pathology, Oslo University Hospital, Rikshospitalet, Oslo, Norway – sequence: 13 givenname: Lois orcidid: 0000-0001-5434-7630 surname: Arend fullname: Arend, Lois organization: Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA – sequence: 14 givenname: Miriam orcidid: 0000-0003-3063-0110 surname: Cuatrecasas fullname: Cuatrecasas, Miriam organization: Department of Pathology, Hospital Clìnic de Barcelona, Barcelona, Spain – sequence: 15 givenname: Maria Fernanda orcidid: 0000-0002-3152-6860 surname: Toniolo fullname: Toniolo, Maria Fernanda organization: Centro de Diagnostico Patologico, Buenos Aires, Argentina – sequence: 16 givenname: Alton B. orcidid: 0000-0001-5534-7763 surname: Farris fullname: Farris, Alton B. organization: Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA – sequence: 17 givenname: Karine orcidid: 0009-0003-9505-2718 surname: Renaudin fullname: Renaudin, Karine organization: Department of Pathology, CHU – Hôtel Dieu, Nantes, France – sequence: 18 givenname: Lizhi orcidid: 0000-0001-5829-9234 surname: Zhang fullname: Zhang, Lizhi organization: Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota, USA – sequence: 19 givenname: Candice orcidid: 0000-0002-6490-4290 surname: Roufousse fullname: Roufousse, Candice organization: Department of Immunology and Inflammation, Imperial College of London, London, United Kingdom – sequence: 20 givenname: Angelika orcidid: 0000-0001-5961-5913 surname: Gruessner fullname: Gruessner, Angelika organization: Department of Nephrology/Medicine, State University of New York, New York, USA – sequence: 21 givenname: Rainer orcidid: 0000-0002-2094-9817 surname: Gruessner fullname: Gruessner, Rainer organization: Department of Surgery, State University of New York, New York, USA – sequence: 22 givenname: Raja orcidid: 0000-0003-4302-0119 surname: Kandaswamy fullname: Kandaswamy, Raja organization: Division of Solid Organ Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN, USA – sequence: 23 givenname: Steven orcidid: 0000-0002-6519-9853 surname: White fullname: White, Steven organization: Department of Surgery, Newcastle Upon Tyne NHS Foundation Trust, Newcastle upon Tyne, England, United Kingdom – sequence: 24 givenname: George orcidid: 0000-0002-6888-2842 surname: Burke fullname: Burke, George organization: Division of Kidney-Pancreas Transplantation, Department of Surgery, Miami Transplant Institute, University of Miami Miller School of Medicine, Miami, Florida, USA – sequence: 25 givenname: Diego orcidid: 0009-0006-0247-966X surname: Cantarovich fullname: Cantarovich, Diego organization: Department of Nephrology, CHU – Hôtel Dieu, Nantes, France – sequence: 26 givenname: Ronald F. orcidid: 0000-0002-9243-1582 surname: Parsons fullname: Parsons, Ronald F. organization: Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA – sequence: 27 givenname: Matthew orcidid: 0000-0002-3438-9638 surname: Cooper fullname: Cooper, Matthew organization: Division of Transplant Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA – sequence: 28 givenname: Yogish C. orcidid: 0000-0003-0285-6622 surname: Kudva fullname: Kudva, Yogish C. organization: Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA – sequence: 29 givenname: Aleksandra orcidid: 0000-0001-9576-5687 surname: Kukla fullname: Kukla, Aleksandra organization: Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, USA – sequence: 30 givenname: Abdolreza orcidid: 0000-0002-1810-7987 surname: Haririan fullname: Haririan, Abdolreza organization: Department of Medicine, University of Maryland School of Medicine, Maryland, USA – sequence: 31 givenname: Sandesh orcidid: 0000-0003-1667-7465 surname: Parajuli fullname: Parajuli, Sandesh organization: Department of Medicine, UWHealth Transplant Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA – sequence: 32 givenname: Juan Francisco orcidid: 0000-0002-0191-4504 surname: Merino-Torres fullname: Merino-Torres, Juan Francisco organization: Department of Endocrinology and Nutrition, University Hospital La Fe, La Fe Health Research Institute, University of Valencia, Valencia, Spain – sequence: 33 givenname: Maria orcidid: 0000-0002-4266-8290 surname: Argente-Pla fullname: Argente-Pla, Maria organization: University Hospital La Fe, Health Research Institute La Fe, Valencia, Spain – sequence: 34 givenname: Raphael orcidid: 0000-0001-9050-0436 surname: Meier fullname: Meier, Raphael organization: Department of Surgery, University of Maryland School of Medicine, Maryland, USA – sequence: 35 givenname: Ty orcidid: 0000-0002-5941-0659 surname: Dunn fullname: Dunn, Ty organization: Division of Transplantation, Department of Surgery, Penn Transplant Institute, University of Pennsylvania, Pennsylvania, Philadelphia, USA – sequence: 36 givenname: Richard orcidid: 0000-0002-0561-1455 surname: Ugarte fullname: Ugarte, Richard organization: Department of Medicine, University of Maryland School of Medicine, Maryland, USA – sequence: 37 givenname: Joseph Sushil orcidid: 0000-0002-0197-6107 surname: Rao fullname: Rao, Joseph Sushil organization: Division of Solid Organ Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN, USA – sequence: 38 givenname: Fabio orcidid: 0000-0003-2115-4191 surname: Vistoli fullname: Vistoli, Fabio organization: Department of Surgery, University of Pisa, Pisa, The province of Pisa, Italy – sequence: 39 givenname: Robert orcidid: 0000-0001-7634-094X surname: Stratta fullname: Stratta, Robert organization: Department of Surgery, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina, USA – sequence: 40 givenname: Jon orcidid: 0000-0003-1096-464X surname: Odorico fullname: Odorico, Jon organization: Division of Transplantation, Department of Surgery, UWHealth Transplant Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/37871799$$D View this record in MEDLINE/PubMed |
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Keywords | percutaneous pancreas biopsy DM PNF solitary pancreas transplant T1DR antibody-mediated rejection dd cf DNA SPK pancreas after kidney transplant simultaneous pancreas kidney transplant DSA PTLD HbA1c donor-specific antibody DGF PTxBx acute T cell–mediated rejection AMR AI CIN IAC whole pancreas transplantation CMV Igls criteria AR C4d TF CD3 GEP TCMR mixed rejection PAK CD68 dnDSA PTA |
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SubjectTerms | acute T cell–mediated rejection antibody-mediated rejection Biopsy donor-specific antibody Isoantibodies mixed rejection pancreas after kidney transplant Pancreas Transplantation percutaneous pancreas biopsy simultaneous pancreas kidney transplant solitary pancreas transplant T-Lymphocytes Transplantation, Homologous whole pancreas transplantation |
Title | Banff 2022 pancreas transplantation multidisciplinary report: Refinement of guidelines for T cell–mediated rejection, antibody-mediated rejection and islet pathology. Assessment of duodenal cuff biopsies and noninvasive diagnostic methods |
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