Background. After the changes in 2013 Banff classification, there has been an improvement in diagnosing antibody-mediated rejection (ABMR) in adult studies but no data in the paediatric population. Methods. We assessed 56 paediatric renal transplant biopsies due to renal dysfunction in patients with donor-specific antibodies (DSA) in a retrospective single-centre study between January 2006 and March 2012. The results were compared with 2003/2007 Banff classification. Results. Following the 2013 Banff classification, there were 7 cases (12.5%) diagnosed with ABMR that would have been misclassified when applying the 2003/2007 classification. Evaluating the histological features of all the ABMR-related cases we report the importance of v-(intimal arteritis) and t-(tubulitis) lesions: the absence of vand t-lesions in the biopsy is related to a significantly higher graft survival (OR 7.3, 95%CI 1.1 -48.8, p = 0.03 and OR 5.3, 95%CI 1.2 -25.5, p = 0.04 respectively). Moreover, the absence of t-lesions was associated with significantly less rejection episodes the year after the initial biopsy (OR 5.1, 95%CI 1.4 -19.8, p = 0.01).
Conclusion.Considering the clinical outcomes in our cohort we support the 2013 Banff classification as a more precise tool in identifying ABMR in the pediatric population.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.