Banff 2022 pancreas transplantation multidisciplinary report: Refinement of guidelines for T cell–mediated rejection, antibody-mediated rejection and islet pathology. Assessment of duodenal cuff biopsies and noninvasive diagnostic methods

Drachenberg CB, Büttner-Herold M, Aguiar PV, Horsfield C, Mikhailov AV, Papadimitriou JC, Seshan SV, Perosa M, Boggi U, Uva P, Rickels M, Grzyb K, Arend L, Cuatrecasas M, Toniolo MF, Farris AB, Renaudin K, Zhang L, Roufousse C, Gruessner A, Gruessner R, Kandaswamy R, White S, Burke G, Cantarovich D, Parsons RF, Cooper M, Kudva YC, Kukla A, Haririan A, Parajuli S, Merino-Torres JF, Argente-Pla M, Meier R, Dunn T, Ugarte R, Rao JS, Vistoli F, Stratta R, Odorico J (2024)

Publication Type: Journal article

Publication year: 2024

Journal

Book Volume: 24

Pages Range: 362-379

Journal Issue: 3

DOI: 10.1016/j.ajt.2023.10.011

Abstract

The Banff pancreas working schema for diagnosis and grading of rejection is widely used for treatment guidance and risk stratification in centers that perform pancreas allograft biopsies. Since the last update, various studies have provided additional insight regarding the application of the schema and enhanced our understanding of additional clinicopathologic entities. This update aims to clarify terminology and lesion description for T cell–mediated and antibody-mediated allograft rejections, in both active and chronic forms. In addition, morphologic and immunohistochemical tools are described to help distinguish rejection from nonrejection pathologies. For the first time, a clinicopathologic approach to islet pathology in the early and late posttransplant periods is discussed. This update also includes a discussion and recommendations on the utilization of endoscopic duodenal donor cuff biopsies as surrogates for pancreas biopsies in various clinical settings. Finally, an analysis and recommendations on the use of donor-derived cell-free DNA for monitoring pancreas graft recipients are provided. This multidisciplinary effort assesses the current role of pancreas allograft biopsies and offers practical guidelines that can be helpful to pancreas transplant practitioners as well as experienced pathologists and pathologists in training.

Authors with CRIS profile

Involved external institutions

Hospital Clínic de Barcelona Spain (ES) Guy's and St Thomas' (NHS Foundation Trust) United Kingdom (GB) Atrium Health Wake Forest Baptist (prev. Wake Forest Baptist Medical Center) United States (USA) (US) University of Maryland School of Pharmacy United States (USA) (US) Weill Cornell Medicine United States (USA) (US) Beneficência Portuguesa de São Paulo Brazil (BR) Instituto de Trasplante de Alta Complejidad (ITAC) Argentina (AR) Hospital of the University of Pennsylvania (HUP) United States (USA) (US) Oslo University Hospital / Oslo Universitetssykehus Rikshospitalet Norway (NO) Johns Hopkins Hospital United States (USA) (US) University of Pisa / Università di Pisa (UniPi) Italy (IT) Emory University United States (USA) (US) Mayo Clinic United States (USA) (US) Imperial College London / The Imperial College of Science, Technology and Medicine United Kingdom (GB) State University of New York at Albany (UNY Albany / UAlbany) United States (USA) (US) University of Minnesota (UMN) United States (USA) (US) Newcastle upon Tyne Hospitals NHS Foundation Trust United Kingdom (GB) Miami Transplant Institute United States (USA) (US) Nantes University Hospital / Centre hospitalier universitaire de Nantes (CHU) France (FR) Medical College of Wisconsin (MCW) United States (USA) (US) Mayo Clinic College of Medicine and Science (MCCMS) United States (USA) (US) University of Wisconsin - Madison United States (USA) (US) Hospital Universitario y Politécnico de La Fe Spain (ES) Penn Medicine United States (USA) (US)

How to cite

APA:

Drachenberg, C.B., Büttner-Herold, M., Aguiar, P.V., Horsfield, C., Mikhailov, A.V., Papadimitriou, J.C.,... Odorico, J. (2024). Banff 2022 pancreas transplantation multidisciplinary report: Refinement of guidelines for T cell–mediated rejection, antibody-mediated rejection and islet pathology. Assessment of duodenal cuff biopsies and noninvasive diagnostic methods. American Journal of Transplantation, 24(3), 362-379. https://doi.org/10.1016/j.ajt.2023.10.011

MLA:

Drachenberg, Cinthia B., et al. "Banff 2022 pancreas transplantation multidisciplinary report: Refinement of guidelines for T cell–mediated rejection, antibody-mediated rejection and islet pathology. Assessment of duodenal cuff biopsies and noninvasive diagnostic methods." American Journal of Transplantation 24.3 (2024): 362-379.

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