A Banff Component Scoring-based Histologic Assessment of XXXX -based Antibody-mediated Rejection Therapy.

@entity1 @entity32 @entity9538 @entity82 @entity194 @entity1749 @entity2483
BACKGROUND: Histology remains a cornerstone for antibody-mediated rejection (AMR) diagnosis. Little data exist supporting histology for assessing therapeutic responses. This study evaluates histologic components in assessing AMR therapeutic responses. METHODS: Antibody-mediated rejection was diagnosed using Antibody Working Group criteria and Banff component scoring, and C4d staining data were analyzed. Statistics included independent and paired samples t test,   , Fisher exact, or the Wilcoxon-signed rank test. Fifty-five AMR @entity1 were analyzed. Early AMR was defined as occurring within 6 months after transplantation and treated with a single rituximab dose and 4 @entity1749 doses preceded by plasmapheresis. Allograft biopsies were performed within 48 hours of treatment; repeat biopsy was performed 14 to 21 days later. RESULTS: Early AMR demonstrated histologic improvement in mean scores for acute Banff components glomerulitis (g), C4d, g+ peritubular capillaritis (ptc) and acute composite score, but showed @entity194 and @entity82 . Late AMR showed improved mean scores for acute @entity2483 , @entity32 , g, ptc, g + ptc, C4d, and acute composite score, but chronic scores did not change. Significant changes in distribution of Banff scores after treatment were observed for g, C4d, tubular @entity194 , and @entity82 scores in early AMR @entity1 and @entity9538 , @entity32 , g, ptc, and C4d in late AMR. CONCLUSIONS: These results show that: (1) Banff component scoring provides insights into histologic responses to AMR therapy and may provide a potential endpoint for clinical AMR trials. (2) Early and late AMR demonstrate differences in acute and chronic Banff components at the time of the AMR diagnostic biopsy, as well as differential responses to AMR therapy.
