Renal allograft rejection in children and young adults

the Banff classification

H. E. Corey, Stuart M. Greenstein, V. Tellis, R. Schechner, I. Greifer, B. Bennett

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

In the Banff classification, arteritis and tubulitis are regarded as the principal histological lesions indicating acute renal allograft rejection. To test this claim, we examined 51 biopsies obtained from 21 children and young adults with transplant rejection. Two reviewers, blind to the clinical course, graded the biopsies according to the Banff scheme. In patients without significant tubulitis (borderline changes), rejection tended to be reversed easily (88%), often with methylprednisolone pulse (52%). In patients with arteritis or significant tubulitis (Banff I-III), rejection was reversed in only 23% (P < 0.001), in 9% with steroids, and in 14% with OKT3. Salvage of the graft was achieved in 26 of 35 (74%) with a score < 5 but in only 1 of 12 (8%) with a score ≥5 (P < 0.001). All 6 patients with vasculitis lost their grafts despite methylprednisolone pulse and OKT3. We conclude that the Banff classification predicts accurately the outcome of renal allograft rejection in children and may aid in choosing appropriate therapy.

Original languageEnglish (US)
Pages (from-to)309-312
Number of pages4
JournalPediatric Nephrology
Volume9
Issue number3
DOIs
StatePublished - Jun 1995

Fingerprint

Allografts
Muromonab-CD3
Young Adult
Arteritis
Methylprednisolone
Kidney
Transplants
Biopsy
Graft Rejection
Vasculitis
Steroids
Therapeutics

Keywords

  • Banff classification
  • Rejection
  • Tubulitis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

Cite this

Renal allograft rejection in children and young adults : the Banff classification. / Corey, H. E.; Greenstein, Stuart M.; Tellis, V.; Schechner, R.; Greifer, I.; Bennett, B.

In: Pediatric Nephrology, Vol. 9, No. 3, 06.1995, p. 309-312.

Research output: Contribution to journalArticle

Corey, HE, Greenstein, SM, Tellis, V, Schechner, R, Greifer, I & Bennett, B 1995, 'Renal allograft rejection in children and young adults: the Banff classification', Pediatric Nephrology, vol. 9, no. 3, pp. 309-312. https://doi.org/10.1007/BF02254194
Corey, H. E. ; Greenstein, Stuart M. ; Tellis, V. ; Schechner, R. ; Greifer, I. ; Bennett, B. / Renal allograft rejection in children and young adults : the Banff classification. In: Pediatric Nephrology. 1995 ; Vol. 9, No. 3. pp. 309-312.
@article{8c4e1ee947dd4003a6bef8c513c65c71,
title = "Renal allograft rejection in children and young adults: the Banff classification",
abstract = "In the Banff classification, arteritis and tubulitis are regarded as the principal histological lesions indicating acute renal allograft rejection. To test this claim, we examined 51 biopsies obtained from 21 children and young adults with transplant rejection. Two reviewers, blind to the clinical course, graded the biopsies according to the Banff scheme. In patients without significant tubulitis (borderline changes), rejection tended to be reversed easily (88{\%}), often with methylprednisolone pulse (52{\%}). In patients with arteritis or significant tubulitis (Banff I-III), rejection was reversed in only 23{\%} (P < 0.001), in 9{\%} with steroids, and in 14{\%} with OKT3. Salvage of the graft was achieved in 26 of 35 (74{\%}) with a score < 5 but in only 1 of 12 (8{\%}) with a score ≥5 (P < 0.001). All 6 patients with vasculitis lost their grafts despite methylprednisolone pulse and OKT3. We conclude that the Banff classification predicts accurately the outcome of renal allograft rejection in children and may aid in choosing appropriate therapy.",
keywords = "Banff classification, Rejection, Tubulitis",
author = "Corey, {H. E.} and Greenstein, {Stuart M.} and V. Tellis and R. Schechner and I. Greifer and B. Bennett",
year = "1995",
month = "6",
doi = "10.1007/BF02254194",
language = "English (US)",
volume = "9",
pages = "309--312",
journal = "Pediatric Nephrology",
issn = "0931-041X",
publisher = "Springer Verlag",
number = "3",

}

TY - JOUR

T1 - Renal allograft rejection in children and young adults

T2 - the Banff classification

AU - Corey, H. E.

AU - Greenstein, Stuart M.

AU - Tellis, V.

AU - Schechner, R.

AU - Greifer, I.

AU - Bennett, B.

PY - 1995/6

Y1 - 1995/6

N2 - In the Banff classification, arteritis and tubulitis are regarded as the principal histological lesions indicating acute renal allograft rejection. To test this claim, we examined 51 biopsies obtained from 21 children and young adults with transplant rejection. Two reviewers, blind to the clinical course, graded the biopsies according to the Banff scheme. In patients without significant tubulitis (borderline changes), rejection tended to be reversed easily (88%), often with methylprednisolone pulse (52%). In patients with arteritis or significant tubulitis (Banff I-III), rejection was reversed in only 23% (P < 0.001), in 9% with steroids, and in 14% with OKT3. Salvage of the graft was achieved in 26 of 35 (74%) with a score < 5 but in only 1 of 12 (8%) with a score ≥5 (P < 0.001). All 6 patients with vasculitis lost their grafts despite methylprednisolone pulse and OKT3. We conclude that the Banff classification predicts accurately the outcome of renal allograft rejection in children and may aid in choosing appropriate therapy.

AB - In the Banff classification, arteritis and tubulitis are regarded as the principal histological lesions indicating acute renal allograft rejection. To test this claim, we examined 51 biopsies obtained from 21 children and young adults with transplant rejection. Two reviewers, blind to the clinical course, graded the biopsies according to the Banff scheme. In patients without significant tubulitis (borderline changes), rejection tended to be reversed easily (88%), often with methylprednisolone pulse (52%). In patients with arteritis or significant tubulitis (Banff I-III), rejection was reversed in only 23% (P < 0.001), in 9% with steroids, and in 14% with OKT3. Salvage of the graft was achieved in 26 of 35 (74%) with a score < 5 but in only 1 of 12 (8%) with a score ≥5 (P < 0.001). All 6 patients with vasculitis lost their grafts despite methylprednisolone pulse and OKT3. We conclude that the Banff classification predicts accurately the outcome of renal allograft rejection in children and may aid in choosing appropriate therapy.

KW - Banff classification

KW - Rejection

KW - Tubulitis

UR - http://www.scopus.com/inward/record.url?scp=0029008786&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029008786&partnerID=8YFLogxK

U2 - 10.1007/BF02254194

DO - 10.1007/BF02254194

M3 - Article

VL - 9

SP - 309

EP - 312

JO - Pediatric Nephrology

JF - Pediatric Nephrology

SN - 0931-041X

IS - 3

ER -