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班夫测试对拒绝分类和结果的影响:来自多中心研究的见解

Karolien Wellekens¹, Maarten Coemans², Priyanka Koshy¹

¹Nephrology and Renal Transplantation Research Group, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium; Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium.

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

|May 7, 2025

概括

脏移植中的内极性动脉炎 (v-损伤) 可能不会显著影响结果. 对T细胞中介排斥 (TCMR) 和抗体中介排斥 (AMR) 的额外标准对预后更为关键.

科学领域:

腎臟病學 (nephrology) 是一種醫學專業.
移植免疫学移植免疫学
病理学病理学病理学

背景情况:

最终性动脉炎 (v-损伤) 是班夫分类特征,用于诊断T细胞介导排斥 (TCMR) 和抗体介导排斥 (AMR).
V-损伤被认为表明更严重的TCMR,但它们的独立预后值需要进一步评估.

研究的目的:

评估视损伤对移植活检分类和长期结果的影响.
评估孤立的v-损伤与与其他拒绝标准结合的v-损伤的预后意义.

主要方法:

多中心队列研究,对5323例脏移植和16774例移植后活检进行了研究.
分析了来自534例移植的707例v阳性活检,根据班夫TCMR/pAMR-MVI标准进行分类.
比较v-阳性和v-阴性病例之间的结果,以及不同类型的v-损伤之间的结果.

主要成果:

V-损伤被分类为孤立的v (31.1%),边界变化与v (16.3%),TCMR等级I与v (12.4%), (p) AMR-MVI与v (27.7%),和TCMR-I + (p) AMR-MVI与v (12.5%).
附加TCMR/p) AMR-MVI标准的病例显示,与孤立的v-损伤相比,移植结果较差.
当v阳性病例与v阴性对照匹配时,没有观察到v损伤对结果的显著影响.

结论:

孤立的v-损伤本身可能在移植排斥中具有有限的预后价值.
在v损伤存在的情况下,额外的TCMR和 (p) AMR-MVI标准与更糟糕的结果密切相关.
在班夫系统中重新考虑v-lesions的作用和分类可能是合理的.

关键词:

班夫分类是班夫分类中的一个.腎臟移植腎臟移植拒绝拒绝拒绝

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