Lung allograft standardized histological analysis (LASHA) template: A research consensus proposal

Area of Science:

• Pulmonary Medicine
• Transplantation Immunology
• Pathology

Background:

• Lung transplant recipients require routine monitoring for immunological and non-immunological complications.
• Histopathologic analysis of lung biopsies is essential for diagnosing acute allograft dysfunction, especially alloimmune-mediated disorders.
• Standardized pathological diagnosis of rejection (cellular and antibody-mediated) relies on consensus guidelines and a multidisciplinary approach.

Purpose of the Study:

• To identify key morphologic features for lung allograft biopsy assessment.
• To establish consistent and reproducible terminology for histological features.
• To provide standardized definitions for pathological assessment and grading of lung allograft biopsies.

Main Methods:

• A multidisciplinary expert panel developed a template for lung allograft standardized histological analysis (LASHA).
• The template involved iterative revisions through email and conference calls.
• The LASHA template was structured with multiple-choice questions for standardized data collection.

Main Results:

• The "lung allograft standardized histological analysis - LASHA" template was created.
• The template facilitates standardization of results and data transfer to electronic spreadsheets.
• The LASHA template aims to standardize pathological assessment of lung allografts.

Conclusions:

• The LASHA template can facilitate multicenter studies via a uniform protocol.
• It allows for correlations with emerging diagnostic modalities.
• Validation in large-scale studies may lead to its inclusion in routine clinical practice for enhanced graft assessment and decision-making.