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Thrombotic Microangiopathy in the Renal Allograft: Results of the TMA Banff Working Group Consensus on Pathologic Diagnostic Criteria

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  • 06/17/2025
Type of Material
Authors
    Marjan Afrouzian, University of Texas, GalvestonNicolas Kozakowski, University of ViennaHelen Liapis, University of MunichVerena Broecker, Sahlgrenska University HospitalLuon Truong, The Houston Methodist HospitalCarmen Avila-Casado, University Health Network, TorontoHeinz Regele, University of ViennaSurya Seshan, Weill Cornell MedicineJosephine M. Ambruzs, Arkana LaboratoriesAlton B Farris III, Emory UniversityDavid Buob, Université de SorbonnePraveen N. Chander, New York Medical CollegeLukman Cheraghvandi, Baylor College of MedicineMarian C. Clahsen-van Groningen, Erasmus University Center RotterdamStanley de Almeida Araujo, Universidade Federal de Minas GeraisDilek Ertoy Baydar, University School of Medicine, IstanbulMark Formby, The University of NewcastleDanica Galesic Ljubanovic, University of ZagrebLoren Herrera Hernandez, Mayo Clinic, RochesterEva Honsova, Charles UniversityNasreen Mohamed, King Fahad Specialist Hospital-DammamYasemin Ozluk, Istanbul Universitymarion Rabant, Université Paris CitéVirginie Royal, University of MontrealHeather L. Stevenson, University of Texas, GalvestonMaria Fernanda Toniolo, Instituto de Nefrología-NephrologyDiana Taheri, Isfahan University of Medical Sciences
Language
  • English
Date
  • 2023-08-23
Publisher
  • Frontiers
Publication Version
Copyright Statement
  • © 2023 Afrouzian, Kozakowski, Liapis, Broecker, Truong, Avila-Casado, Regele, Seshan, Ambruzs, Farris, Buob, Chander, Cheraghvandi, Clahsen-van Groningen, de Almeida Araujo, Ertoy Baydar, Formby, Galesic Ljubanovic, Herrera Hernandez, Honsova, Mohamed, Ozluk, Rabant, Royal, Stevenson, Toniolo and Taheri.
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Final Published Version (URL)
Title of Journal or Parent Work
Volume
  • 36
Start Page
  • 11590
Grant/Funding Information
  • This study was performed under the auspices of the Banff Foundation on Allograft Pathology and supported by grants from the Banff Foundation (for publication fees) and Alexion Pharmaceuticals (#100288).
Supplemental Material (URL)
Abstract
  • The Banff community summoned the TMA Banff Working Group to develop minimum diagnostic criteria (MDC) and recommendations for renal transplant TMA (Tx-TMA) diagnosis, which currently lacks standardized criteria. Using the Delphi method for consensus generation, 23 nephropathologists (panelists) with >3 years of diagnostic experience with Tx-TMA were asked to list light, immunofluorescence, and electron microscopic, clinical and laboratory criteria and differential diagnoses for Tx-TMA. Delphi was modified to include 2 validations rounds with histological evaluation of whole slide images of 37 transplant biopsies (28 TMA and 9 non-TMA). Starting with 338 criteria in R1, MDC were narrowed down to 24 in R8 generating 18 pathological, 2 clinical, 4 laboratory criteria, and 8 differential diagnoses. The panelists reached a good level of agreement (70%) on 76% of the validated cases. For the first time in Banff classification, Delphi was used to reach consensus on MDC for Tx-TMA. Phase I of the study (pathology phase) will be used as a model for Phase II (nephrology phase) for consensus regarding clinical and laboratory criteria. Eventually in Phase III (consensus of the consensus groups) and the final MDC for Tx-TMA will be reported to the transplantation community.
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Research Categories
  • Health Sciences, Medicine and Surgery

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