The Prognostic Significance of Banff Classification Lesions in Determining Renal Allograft Survival During Chronic Active Antibody-mediated Rejection Kronik Aktif Antikor Aracılı Rejeksiyonda Banff Lezyonlarının Böbrek Allograft Sağkalımına Etkileri
Anatolian Journal of General Medical Research, cilt.36, sa.1, ss.21-28, 2026 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 36 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.4274/anatoljmed.2025.19870
- Dergi Adı: Anatolian Journal of General Medical Research
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.21-28
- Anahtar Kelimeler: Banff lesions, chronic active antibody-mediated rejection, microvascular inflammation, renal transplantation
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Chronic active antibody-mediated rejection (ca-ABMR) has been identified as a primary cause of graft loss in kidney transplant recipients over an extended period. The outcomes of intravenous immunoglobulin and plasmapheresis treatments in ca-ABMR are controversial; therefore, no established effective treatment has yet been found. This study aims to identify the clinical and histopathological parameters that influence the decision to treat or not treat ca-ABMR cases. Methods: Fourteen patients diagnosed with ca-ABMR, who underwent biopsy with a pre-diagnosis of kidney rejection between 2018 and 2024 at the pathology department, were included in the study. The histopathological features were evaluated using the Banff 2019 criteria. Results: 28.6% of the patients (n=4) were female, and 71.4% (n=10) were male. The mean age of male patients was 46.40±12.63 years, while the mean age of female patients was 33.00±16.39 years. The average time from kidney transplantation to biopsy was 56.85±47.27 months. No statistically significant differences were found between the treated (n=10) and untreated (n=4) groups in terms of microvascular inflammation score (p=0.88), chronic tissue damage score (p=0.87), transplant glomerulopathy (p=0.99), intimal arteritis (p=0.99), and immunohistochemical C4d staining score (p=0.50). However, the high-risk group for microvascular inflammation (glomerulitis+peritubular capillaritis) had a significantly longer survival time than the low-risk group (p=0.03 <0.05). No statistically significant difference in survival time was found between the low-and high-risk groups for chronic tissue damage (tubular atrophy+interstitial fibrosis+total inflammation) score, (p=0.56 >0.05). No statistically significant differences were found in Banff lesion scores between the treated and untreated groups. Conclusion: The early detection of graft histopathological changes, often achieved through protocol biopsies, facilitates the identification of ca-ABMR patients who will respond favorably to treatment.