Acute renal allograft rejection with severe tubulitis (Banff 1997 grade Ib)

Marta Ida Minervini, Michael Torbenson, Velma Scantlebury, Carlos Vivas, Mark Jordan, Ron Shapiro, Parmjeet S. Randhawa

Research output: Contribution to journalArticlepeer-review

Abstract

Recent studies have correlated renal allograft function with individual histologic lesions defined in the Banff schema of kidney transplantation pathology. The clinical significance of severe tubulitis (Banff 97 grade t3) has not been specifically examined. We compared the clinical course and response to antirejection therapy in 36 patients with t3 tubulitis, and 137 patients with milder grades of tubulitis and varying grades of intimal arteritis. Rejection associated with severe tubulitis (grade t3) was associated with graft outcome that was worse than mild to moderate tubulitis (grades t1 or t2) and approached that seen in grade v1 intimal arteritis. Rejection characterized by grade v2 or v3 intimal arteritis had worse prognosis than v1 intimal arteritis and all grades of tubulitis without coexisting intimal arteritis. These observations validate the Banff 97 recommendation that the severity of both tubulitis and intimal arteritis needs to be graded in renal allograft biopsies. In addition, grade t3 tubulitis is identified as a lesion which should be a cause for clinical concern.

Original languageEnglish (US)
Pages (from-to)553-558
Number of pages6
JournalAmerican Journal of Surgical Pathology
Volume24
Issue number4
DOIs
StatePublished - Apr 2000
Externally publishedYes

Keywords

  • Allograft
  • Banff
  • Intimal arteritis
  • Pathology
  • Rejection
  • Renal transplantation
  • Severe tubulitis

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

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