Evaluation of pancreas transplant needle biopsy

Reproducibility and revision of histologic grading system

Cinthia B. Drachenberg, John C. Papadimitriou, David K. Klassen, Lorraine C Racusen, Edward W. Hoehn-Saric, Matthew R. Weir, Paul C. Kuo, Eugene J. Schweitzer, Lynt B. Johnson, Stephen T. Bartlett

Research output: Contribution to journalArticle

Abstract

Background. Tissue samples for the diagnosis of pancreatic allograft rejection are now obtained routinely through the application of the percutaneous needle biopsy technique. The availability of biopsy material (89% adequate for diagnosis in our setting) presents a challenge for pathologists who are asked to provide a fast and accurate diagnosis of rejection and its severity, while at the same time being able to differentiate rejection from other causes of graft dysfunction. Methods. To differentiate rejection from other pathologic processes, 26 histologic features were assessed in 92 biopsies performed for confirmation of clinical diagnosis of rejection and the results were compared with 31 protocol biopsies, 12 allograft pancreatectomies with non-rejection pathology, and 30 native pancreas resections with various disease processes. Results. Based on these comparisons, a constellation of findings relating to the vascular, septal, and acinar inflammation was identified for the diagnosis of rejection. Application of these features led us to revise our scheme for grading rejection (ranging from 0-normal to V-severe rejection) to include the categories of 'inflammation of undetermined significance' and 'minimal rejection.' The scheme was used by five pathologist to grade 20 biopsies independently of any clinical data and the interobserver level of agreement was highly significant (κ=0.83, P

Original languageEnglish (US)
Pages (from-to)1579-1586
Number of pages8
JournalTransplantation
Volume63
Issue number11
DOIs
StatePublished - Jun 15 1997

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Needle Biopsy
Pancreas
Transplants
Biopsy
Allografts
Inflammation
Pancreatectomy
Pathologic Processes
Blood Vessels
Pathology
Pathologists

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Drachenberg, C. B., Papadimitriou, J. C., Klassen, D. K., Racusen, L. C., Hoehn-Saric, E. W., Weir, M. R., ... Bartlett, S. T. (1997). Evaluation of pancreas transplant needle biopsy: Reproducibility and revision of histologic grading system. Transplantation, 63(11), 1579-1586. https://doi.org/10.1097/00007890-199706150-00007

Evaluation of pancreas transplant needle biopsy : Reproducibility and revision of histologic grading system. / Drachenberg, Cinthia B.; Papadimitriou, John C.; Klassen, David K.; Racusen, Lorraine C; Hoehn-Saric, Edward W.; Weir, Matthew R.; Kuo, Paul C.; Schweitzer, Eugene J.; Johnson, Lynt B.; Bartlett, Stephen T.

In: Transplantation, Vol. 63, No. 11, 15.06.1997, p. 1579-1586.

Research output: Contribution to journalArticle

Drachenberg, CB, Papadimitriou, JC, Klassen, DK, Racusen, LC, Hoehn-Saric, EW, Weir, MR, Kuo, PC, Schweitzer, EJ, Johnson, LB & Bartlett, ST 1997, 'Evaluation of pancreas transplant needle biopsy: Reproducibility and revision of histologic grading system', Transplantation, vol. 63, no. 11, pp. 1579-1586. https://doi.org/10.1097/00007890-199706150-00007
Drachenberg CB, Papadimitriou JC, Klassen DK, Racusen LC, Hoehn-Saric EW, Weir MR et al. Evaluation of pancreas transplant needle biopsy: Reproducibility and revision of histologic grading system. Transplantation. 1997 Jun 15;63(11):1579-1586. https://doi.org/10.1097/00007890-199706150-00007
Drachenberg, Cinthia B. ; Papadimitriou, John C. ; Klassen, David K. ; Racusen, Lorraine C ; Hoehn-Saric, Edward W. ; Weir, Matthew R. ; Kuo, Paul C. ; Schweitzer, Eugene J. ; Johnson, Lynt B. ; Bartlett, Stephen T. / Evaluation of pancreas transplant needle biopsy : Reproducibility and revision of histologic grading system. In: Transplantation. 1997 ; Vol. 63, No. 11. pp. 1579-1586.
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