Banff study of pathologic changes in lung allograft biopsy specimens with donor-specific antibodies

William Dean Wallace; Ning Li; Claus B Andersen; A Valeria Arrossi; Medhat Askar; Gerry J Berry; Matthew M DeNicola; Desley A Neil; Elizabeth N Pavlisko; Elaine F Reed; Myriam Remmelink; S Sam Weigt; Birgit Weynand; Jennifer Q Zhang; Marie M Budev; Carol F Farver

doi:10.1016/j.healun.2015.08.021

Banff study of pathologic changes in lung allograft biopsy specimens with donor-specific antibodies

William Dean Wallace, Ning Li, Claus B Andersen, A Valeria Arrossi, Medhat Askar, Gerry J Berry, Matthew M DeNicola, Desley A Neil, Elizabeth N Pavlisko, Elaine F Reed, Myriam Remmelink, S Sam Weigt, Birgit Weynand, Jennifer Q Zhang, Marie M Budev, Carol F Farver

IKM

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

37 Citationer (Scopus)

Abstract

BACKGROUND: The diagnosis of antibody-mediated rejection (AMR) in the lung transplant is still an area under investigation. We performed a blinded multicenter study to determine if any statistically significant histologic findings in transbronchial biopsy specimens from lung transplant patients correlate with the presence of donor-specific antibodies (DSAs).

METHODS: We asked 9 pathologists with experience in lung transplantation to evaluate 161 lung transplant biopsy specimens for various histologic parameters. The findings were correlated with antibody status positive for DSAs, positive for non-DSAs, and no antibodies (NABs) present. The significance of each histologic variable was reviewed.

RESULTS: We found no statistically significant association with acute cellular rejection, airway inflammation, or bronchiolitis obliterans and the presence or absence of antibodies. However, biopsy specimens with DSAs had a statistically significant difference vs NABs in the setting of acute lung injury, with or without diffuse alveolar damage (p = 0.0008), in the presence of capillary neutrophilic inflammation (p = 0.0014), and in samples with endotheliitis (p = 0.0155). In samples with complement 4d staining, there was a trend but no statistically significant difference between specimens associated with DSAs and specimens with NABs.

CONCLUSIONS: Capillary inflammation, acute lung injury, and endotheliitis significantly correlated with DSAs. The infrequently observed diffuse staining for complement 4d limits the usefulness of this stain.

Originalsprog	Engelsk
Tidsskrift	Journal of Heart and Lung Transplantation
Vol/bind	35
Udgave nummer	1
Sider (fra-til)	40-8
Antal sider	9
ISSN	1053-2498
DOI	https://doi.org/10.1016/j.healun.2015.08.021
Status	Udgivet - jan. 2016

Adgang til dokumentet

10.1016/j.healun.2015.08.021

Citationsformater

Wallace, W. D., Li, N., Andersen, C. B., Arrossi, A. V., Askar, M., Berry, G. J., DeNicola, M. M., Neil, D. A., Pavlisko, E. N., Reed, E. F., Remmelink, M., Weigt, S. S., Weynand, B., Zhang, J. Q., Budev, M. M., & Farver, C. F. (2016). Banff study of pathologic changes in lung allograft biopsy specimens with donor-specific antibodies. Journal of Heart and Lung Transplantation, 35(1), 40-8. https://doi.org/10.1016/j.healun.2015.08.021

Banff study of pathologic changes in lung allograft biopsy specimens with donor-specific antibodies. / Wallace, William Dean; Li, Ning; Andersen, Claus B; Arrossi, A Valeria; Askar, Medhat; Berry, Gerry J; DeNicola, Matthew M; Neil, Desley A; Pavlisko, Elizabeth N; Reed, Elaine F; Remmelink, Myriam; Weigt, S Sam; Weynand, Birgit; Zhang, Jennifer Q; Budev, Marie M; Farver, Carol F.

I: Journal of Heart and Lung Transplantation, Bind 35, Nr. 1, 01.2016, s. 40-8.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Wallace, WD, Li, N, Andersen, CB, Arrossi, AV, Askar, M, Berry, GJ, DeNicola, MM, Neil, DA, Pavlisko, EN, Reed, EF, Remmelink, M, Weigt, SS, Weynand, B, Zhang, JQ, Budev, MM & Farver, CF 2016, 'Banff study of pathologic changes in lung allograft biopsy specimens with donor-specific antibodies', Journal of Heart and Lung Transplantation, bind 35, nr. 1, s. 40-8. https://doi.org/10.1016/j.healun.2015.08.021

Wallace, William Dean ; Li, Ning ; Andersen, Claus B ; Arrossi, A Valeria ; Askar, Medhat ; Berry, Gerry J ; DeNicola, Matthew M ; Neil, Desley A ; Pavlisko, Elizabeth N ; Reed, Elaine F ; Remmelink, Myriam ; Weigt, S Sam ; Weynand, Birgit ; Zhang, Jennifer Q ; Budev, Marie M ; Farver, Carol F. / Banff study of pathologic changes in lung allograft biopsy specimens with donor-specific antibodies. I: Journal of Heart and Lung Transplantation. 2016 ; Bind 35, Nr. 1. s. 40-8.

@article{66bb834edb6b4a5f9e37f68cb0f0a004,

title = "Banff study of pathologic changes in lung allograft biopsy specimens with donor-specific antibodies",

abstract = "BACKGROUND: The diagnosis of antibody-mediated rejection (AMR) in the lung transplant is still an area under investigation. We performed a blinded multicenter study to determine if any statistically significant histologic findings in transbronchial biopsy specimens from lung transplant patients correlate with the presence of donor-specific antibodies (DSAs).METHODS: We asked 9 pathologists with experience in lung transplantation to evaluate 161 lung transplant biopsy specimens for various histologic parameters. The findings were correlated with antibody status positive for DSAs, positive for non-DSAs, and no antibodies (NABs) present. The significance of each histologic variable was reviewed.RESULTS: We found no statistically significant association with acute cellular rejection, airway inflammation, or bronchiolitis obliterans and the presence or absence of antibodies. However, biopsy specimens with DSAs had a statistically significant difference vs NABs in the setting of acute lung injury, with or without diffuse alveolar damage (p = 0.0008), in the presence of capillary neutrophilic inflammation (p = 0.0014), and in samples with endotheliitis (p = 0.0155). In samples with complement 4d staining, there was a trend but no statistically significant difference between specimens associated with DSAs and specimens with NABs.CONCLUSIONS: Capillary inflammation, acute lung injury, and endotheliitis significantly correlated with DSAs. The infrequently observed diffuse staining for complement 4d limits the usefulness of this stain.",

keywords = "Journal Article, Research Support, Non-U.S. Gov't",

author = "Wallace, {William Dean} and Ning Li and Andersen, {Claus B} and Arrossi, {A Valeria} and Medhat Askar and Berry, {Gerry J} and DeNicola, {Matthew M} and Neil, {Desley A} and Pavlisko, {Elizabeth N} and Reed, {Elaine F} and Myriam Remmelink and Weigt, {S Sam} and Birgit Weynand and Zhang, {Jennifer Q} and Budev, {Marie M} and Farver, {Carol F}",

year = "2016",

month = jan,

doi = "10.1016/j.healun.2015.08.021",

language = "English",

volume = "35",

pages = "40--8",

journal = "Journal of Heart and Lung Transplantation",

issn = "1053-2498",

publisher = "Elsevier",

number = "1",

}

TY - JOUR

T1 - Banff study of pathologic changes in lung allograft biopsy specimens with donor-specific antibodies

AU - Wallace, William Dean

AU - Li, Ning

AU - Andersen, Claus B

AU - Arrossi, A Valeria

AU - Askar, Medhat

AU - Berry, Gerry J

AU - DeNicola, Matthew M

AU - Neil, Desley A

AU - Pavlisko, Elizabeth N

AU - Reed, Elaine F

AU - Remmelink, Myriam

AU - Weigt, S Sam

AU - Weynand, Birgit

AU - Zhang, Jennifer Q

AU - Budev, Marie M

AU - Farver, Carol F

PY - 2016/1

Y1 - 2016/1

N2 - BACKGROUND: The diagnosis of antibody-mediated rejection (AMR) in the lung transplant is still an area under investigation. We performed a blinded multicenter study to determine if any statistically significant histologic findings in transbronchial biopsy specimens from lung transplant patients correlate with the presence of donor-specific antibodies (DSAs).METHODS: We asked 9 pathologists with experience in lung transplantation to evaluate 161 lung transplant biopsy specimens for various histologic parameters. The findings were correlated with antibody status positive for DSAs, positive for non-DSAs, and no antibodies (NABs) present. The significance of each histologic variable was reviewed.RESULTS: We found no statistically significant association with acute cellular rejection, airway inflammation, or bronchiolitis obliterans and the presence or absence of antibodies. However, biopsy specimens with DSAs had a statistically significant difference vs NABs in the setting of acute lung injury, with or without diffuse alveolar damage (p = 0.0008), in the presence of capillary neutrophilic inflammation (p = 0.0014), and in samples with endotheliitis (p = 0.0155). In samples with complement 4d staining, there was a trend but no statistically significant difference between specimens associated with DSAs and specimens with NABs.CONCLUSIONS: Capillary inflammation, acute lung injury, and endotheliitis significantly correlated with DSAs. The infrequently observed diffuse staining for complement 4d limits the usefulness of this stain.

AB - BACKGROUND: The diagnosis of antibody-mediated rejection (AMR) in the lung transplant is still an area under investigation. We performed a blinded multicenter study to determine if any statistically significant histologic findings in transbronchial biopsy specimens from lung transplant patients correlate with the presence of donor-specific antibodies (DSAs).METHODS: We asked 9 pathologists with experience in lung transplantation to evaluate 161 lung transplant biopsy specimens for various histologic parameters. The findings were correlated with antibody status positive for DSAs, positive for non-DSAs, and no antibodies (NABs) present. The significance of each histologic variable was reviewed.RESULTS: We found no statistically significant association with acute cellular rejection, airway inflammation, or bronchiolitis obliterans and the presence or absence of antibodies. However, biopsy specimens with DSAs had a statistically significant difference vs NABs in the setting of acute lung injury, with or without diffuse alveolar damage (p = 0.0008), in the presence of capillary neutrophilic inflammation (p = 0.0014), and in samples with endotheliitis (p = 0.0155). In samples with complement 4d staining, there was a trend but no statistically significant difference between specimens associated with DSAs and specimens with NABs.CONCLUSIONS: Capillary inflammation, acute lung injury, and endotheliitis significantly correlated with DSAs. The infrequently observed diffuse staining for complement 4d limits the usefulness of this stain.

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1016/j.healun.2015.08.021

DO - 10.1016/j.healun.2015.08.021

M3 - Journal article

C2 - 26601715

VL - 35

SP - 40

EP - 48

JO - Journal of Heart and Lung Transplantation

JF - Journal of Heart and Lung Transplantation

SN - 1053-2498

IS - 1

ER -