Diagnosis of acute cellular rejection and antibody-mediated rejection on lung transplant biopsies: A perspective from members of the pulmonary pathology society Journal Article


Authors: Roden, A. C.; Aisner, D. L.; Allen, T. C.; Aubry, M. C.; Barrios, R. J.; Beasley, M. B.; Cagle, P. T.; Capelozzi, V. L.; Dacic, S.; Ge, Y.; Hariri, L. P.; Lantuejoul, S.; Miller, R. A.; Mino-Kenudson, M.; Moreira, A. L.; Raparia, K.; Rekhtman, N.; Sholl, L.; Smith, M. L.; Tsao, M. S.; Vivero, M.; Yatabe, Y.; Yi, E. S.
Article Title: Diagnosis of acute cellular rejection and antibody-mediated rejection on lung transplant biopsies: A perspective from members of the pulmonary pathology society
Abstract: Context.-The diagnosis and grading of acute cellular and antibody-mediated rejection (AMR) in lung allograft biopsies is important because rejection can lead to acute graft dysfunction and/or failure and may contribute to chronic graft failure. While acute cellular rejection is well defined histologically, no reproducible specific features of AMR are currently identified. Therefore, a combination of clinical features, serology, histopathology, and immunologic findings is suggested for the diagnosis of AMR. Objective.-To describe the perspective of members of the Pulmonary Pathology Society (PPS) on the workup of lung allograft transbronchial biopsy and the diagnosis of acute cellular rejection and AMR in lung transplant. Data Sources.-Reports by the International Society for Heart and Lung Transplantation (ISHLT), experience of members of PPS who routinely review lung allograft biopsies, and search of literature database (PubMed). Conclusions.-Acute cellular rejection should be assessed and graded according to the 2007 working formulation of the ISHLT. As currently no specific features are known for AMR in lung allografts, the triple test (clinical allograft dysfunction, donor-specific antibodies, pathologic findings) should be used for its diagnosis. C4d staining might be performed when morphologic, clinical, and/or serologic features suggestive of AMR are identified.
Keywords: pathology; biopsy; immunology; cellular immunity; societies, medical; medical society; graft rejection; humoral immunity; pathology, surgical; lung transplantation; immunity, cellular; immunity, humoral; humans; human
Journal Title: Archives of Pathology & Laboratory Medicine
Volume: 141
Issue: 3
ISSN: 0003-9985
Publisher: College of American Pathologists  
Date Published: 2017-03-01
Start Page: 437
End Page: 444
Language: English
DOI: 10.5858/arpa.2016-0459-SA
PUBMED: 27819763
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 3 April 2017 -- Source: Scopus
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MSK Authors
  1. Natasha Rekhtman
    208 Rekhtman