Efficacy of Acute Cellular Rejection Treatment According to Banff Score in Kidney Transplant Recipients: A Systematic Review

Overview

Journal Transplant Direct

Publisher Wolters Kluwer

Specialty General Surgery

Date 2016 Dec 20

PMID 27990480

Citations 15

Authors

Caroline Lamarche

Jean-Maxime Cote

Lynne Senecal

Heloise Cardinal

Affiliations

Soon will be listed here.

Abstract

Background: The poor prognosis classically associated with Banff grade 2 acute cell-mediated rejection (CMR) may be due to unrecognized antibody-mediated damage. We thus performed a systematic review of the literature to determine the rate of response to treatment in kidney transplant recipients with pure CMR, stratified by Banff class.

Methods: In addition to a manual search, databases interrogated included Excerpta Medica Database (EMBASE), Medical Literature Analysis and Retrieval System Online (MEDLINE), Evidence-Based Medicine (EBM) databases, Central, PubMed and CINAHL. Studies providing functional and/or histological response rates to the treatment of CMR rejection by Banff class (1997 or more recent) were included.

Results: Among the 746 articles identified, 5 articles were included in the final review. Two studies excluded some, and 2 excluded all features of antibody-mediated rejection, while providing data on functional recovery. The absence of functional recovery was reported in 4% of borderline, 15% for Banff grade 1A and IB pooled, 0% to 25% of Banff grade 1B alone, 11% to 20% of Banff grade 2A, and 38% of Banff grade 2B rejections.

Conclusions: The rate of functional recovery of pure Banff IIA CMR overlapped with that of Banff grade 1 CMR, whereas Banff grade 2B showed worse prognosis. There was important heterogeneity in the definition of response to treatment and paucity of data describing the histological response to treatment stratified by Banff class. There is a pressing need to standardize outcome metrics for the reversibility of rejection in kidney transplant recipients in order to design high-quality trials for novel therapeutic alternatives.

Citing Articles

Urinary Chemokines CXCL9 and CXCL10 Are Non-Invasive Biomarkers of Kidney Transplant Rejection.

Macioniene E, Simanavicius M, Vitkauskaite M, Vickiene A, Stauce R, Vinikovas A Ann Transplant. 2024; 29:e944762.

PMID: 39402819 PMC: 11490196. DOI: 10.12659/AOT.944762.

Current Therapies in Kidney Transplant Rejection.

Alasfar S, Kodali L, Schinstock C J Clin Med. 2023; 12(15).

PMID: 37568328 PMC: 10419508. DOI: 10.3390/jcm12154927.

Therapy in the Course of Kidney Graft Rejection-Implications for the Cardiovascular System-A Systematic Review.

Mizera J, Pilch J, Giordano U, Krajewska M, Banasik M Life (Basel). 2023; 13(7).

PMID: 37511833 PMC: 10381422. DOI: 10.3390/life13071458.

Educational Case: Renal allograft rejection.

Dai H, Chen S, Kowalewska J Acad Pathol. 2022; 9(1):100013.

PMID: 35770201 PMC: 9234241. DOI: 10.1016/j.acpath.2022.100013.

Study protocol: the TRAnsplant BIOpsies (TRABIO) study - a prospective, observational, multicentre cohort study to assess the treatment of kidney graft rejections.

von Samson-Himmelstjerna F, Esser G, Schulte K, Kolbrink B, Krautter M, Schwenger V BMJ Open. 2022; 12(4):e048122.

PMID: 35450886 PMC: 9024278. DOI: 10.1136/bmjopen-2020-048122.

References

Vereerstraeten P, Abramowicz D, De Pauw L, Kinnaert P . Absence of deleterious effect on long-term kidney graft survival of rejection episodes with complete functional recovery. Transplantation. 1997; 63(12):1739-43. DOI: 10.1097/00007890-199706270-00006. View

Palomar R, Ruiz J, Zubimendi J, Cotorruelo J, Hernandez E, Rodrigo E . Is there any correlation between pathologic changes for acute rejection in kidney transplantation (Banff 97) and graft function?. Transplant Proc. 2002; 34(1):349. DOI: 10.1016/s0041-1345(01)02794-4. View

Haas M, Kraus E, Samaniego-Picota M, Racusen L, Ni W, Eustace J . Acute renal allograft rejection with intimal arteritis: histologic predictors of response to therapy and graft survival. Kidney Int. 2002; 61(4):1516-26. DOI: 10.1046/j.1523-1755.2002.00254.x. View

Matas A, Smith J, Skeans M, Lamb K, Gustafson S, Samana C . OPTN/SRTR 2011 Annual Data Report: kidney. Am J Transplant. 2012; 13 Suppl 1:11-46. DOI: 10.1111/ajt.12019. View

Lefaucheur C, Loupy A, Vernerey D, Duong-Van-Huyen J, Suberbielle C, Anglicheau D . Antibody-mediated vascular rejection of kidney allografts: a population-based study. Lancet. 2012; 381(9863):313-9. DOI: 10.1016/S0140-6736(12)61265-3. View

Min S, Park Y, Ahn S, Park T, Park D, Kim S . Chronic allograft injury by subclinical borderline change: evidence from serial protocol biopsies in kidney transplantation. J Korean Surg Soc. 2012; 83(6):343-51. PMC: 3514476. DOI: 10.4174/jkss.2012.83.6.343. View

Sis B, Einecke G, Chang J, Hidalgo L, Mengel M, Kaplan B . Cluster analysis of lesions in nonselected kidney transplant biopsies: microcirculation changes, tubulointerstitial inflammation and scarring. Am J Transplant. 2010; 10(2):421-30. DOI: 10.1111/j.1600-6143.2009.02938.x. View

Meier-Kriesche H, Ojo A, Hanson J, Cibrik D, Punch J, Leichtman A . Increased impact of acute rejection on chronic allograft failure in recent era. Transplantation. 2000; 70(7):1098-100. DOI: 10.1097/00007890-200010150-00018. View

Mueller A, Schnuelle P, Waldherr R, van der Woude F . Impact of the Banff '97 classification for histological diagnosis of rejection on clinical outcome and renal function parameters after kidney transplantation. Transplantation. 2000; 69(6):1123-7. DOI: 10.1097/00007890-200003270-00017. View

10.

Guttmann R, Soulillou J, Moore L, First M, Gaber A, Pouletty P . Proposed consensus for definitions and endpoints for clinical trials of acute kidney transplant rejection. Am J Kidney Dis. 1998; 31(6 Suppl 1):S40-6. DOI: 10.1053/ajkd.1998.v31.pm9631863. View

11.

El-Zoghby Z, Stegall M, Lager D, Kremers W, Amer H, Gloor J . Identifying specific causes of kidney allograft loss. Am J Transplant. 2009; 9(3):527-35. DOI: 10.1111/j.1600-6143.2008.02519.x. View

12.

Gaber L, Moore L, Gaber A, Tesi R, Meyer J, Schroeder T . Correlation of histology to clinical rejection reversal: a thymoglobulin multicenter trial report. Kidney Int. 1999; 55(6):2415-22. DOI: 10.1046/j.1523-1755.1999.00494.x. View

13.

Gaber L, Moore L, Alloway R, Flax S, Shokouh-Amiri M, Schroder T . Correlation between Banff classification, acute renal rejection scores and reversal of rejection. Kidney Int. 1996; 49(2):481-7. DOI: 10.1038/ki.1996.68. View

14.

Wu K, Budde K, Lu H, Schmidt D, Liefeldt L, Glander P . The severity of acute cellular rejection defined by Banff classification is associated with kidney allograft outcomes. Transplantation. 2014; 97(11):1146-54. DOI: 10.1097/01.TP.0000441094.32217.05. View

15.

Madden R, Mulhern J, Benedetto B, OShea M, Germain M, Braden G . Completely reversed acute rejection is not a significant risk factor for the development of chronic rejection in renal allograft recipients. Transpl Int. 2000; 13(5):344-50. DOI: 10.1007/s001470050712. View

16.

van den Hoogen M, Hesselink D, van Son W, Weimar W, Hilbrands L . Treatment of steroid-resistant acute renal allograft rejection with alemtuzumab. Am J Transplant. 2012; 13(1):192-6. DOI: 10.1111/j.1600-6143.2012.04328.x. View

17.

Sis B, Bagnasco S, Cornell L, Randhawa P, Haas M, Lategan B . Isolated endarteritis and kidney transplant survival: a multicenter collaborative study. J Am Soc Nephrol. 2014; 26(5):1216-27. PMC: 4413758. DOI: 10.1681/ASN.2014020157. View

18.

Kee T, Chapman J, OConnell P, Fung C, Allen R, Kable K . Treatment of subclinical rejection diagnosed by protocol biopsy of kidney transplants. Transplantation. 2006; 82(1):36-42. DOI: 10.1097/01.tp.0000225783.86950.c2. View

19.

Minervini M, Torbenson M, Scantlebury V, Vivas C, Jordan M, Shapiro R . Acute renal allograft rejection with severe tubulitis (Banff 1997 grade IB). Am J Surg Pathol. 2000; 24(4):553-8. DOI: 10.1097/00000478-200004000-00009. View