ArticleKidney international2023
A Banff-based histologic chronicity index is associated with graft loss in patients with a kidney transplant and antibody-mediated rejection.
Article in Kidney international, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed.
- Donor-derived cell-free DNA monitoring for early diagnosis of antibody-mediated rejection after kidney transplantation: a randomized trial.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025Trial
- Urinary CXCL9 Across the Spectrum of Kidney Allograft Inflammation.Kidney international reports · 2026Article
- Intragraft FOXP3+ Cells and Continuous Banff Indices in T Cell-Mediated Kidney Allograft Rejection.Medicina (Kaunas, Lithuania) · 2026Article
- Biopsy-based Transcriptomics in Banff 2022 Antibody Mediated Rejection Categories.Kidney international reports · 2026Article
- Advances in HLA and Non-HLA Immune Profiling: Integrating Next-Generation Sequencing and Artificial Intelligence in Transplantation.Annals of laboratory medicine · 2026Review
- The Diversity of Transplant Glomerulitis and its Relationship to Alloantibody.Kidney international reports · 2026Article
- DDR2 expression on circulating lymphocytes and monocytes associates with chronic active antibody-mediated rejection in kidney transplant recipients.Translational andrology and urology · 2026Article
- Prognostic impact of rejection and chronicity index on long-term graft outcomes in pediatric kidney transplant recipients.Frontiers in immunology · 2026Article
- Qualified prediction system for allograft failure in real world settings: extended validation study.BMJ medicine · 2026Article
- Advances in antibody-mediated rejection of renal allografts.Frontiers in immunology · 2026Review
- One tool, multiple gains: anti-CD38 therapy in antibody-mediated rejection.Clinical kidney journal · 2025Article
- Continuous indices to assess the phenotypic spectrum of kidney transplant rejection.Nature communications · 2025Article
- Antibody-mediated rejection-treatment standard.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025Review
- Impact of HLA evolutionary divergence and donor-recipient molecular mismatches on antibody-mediated rejection of kidney allografts.Nature communications · 2025Article
- Association of Blood Donor-derived Cell-free DNA Levels With Banff Scores and Histopathological Lesions in Kidney Allograft Biopsies: Results From an Observational Study.Transplantation direct · 2025Article
- TTransplant international : official journal of the European Society for Organ Transplantation · 2025Article
- The Banff 2022 Kidney Meeting Work Plan: Data-driven refinement of the Banff Classification for renal allografts.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2024Article
- Donor-Derived Cell-Free DNA as a Companion Biomarker for AMR Treatment With Daratumumab: Case Series.Transplant international : official journal of the European Society for Organ Transplantation · 2024Article
- Re-Evaluating the Transplant Glomerulopathy Lesion-Beyond Donor-Specific Antibodies.Transplant international : official journal of the European Society for Organ Transplantation · 2024Review
- Perspective for Donor-Derived Cell-Free DNA in Antibody-Mediated Rejection After Kidney Transplantation: Defining Context of Use and Clinical Implications.Transplant international : official journal of the European Society for Organ Transplantation · 2024Review
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10 authors.
Funding
Abstract
Antibody-mediated rejection (AMR) is the major cause of graft loss in kidney transplant recipients. The Banff classification defines two classes of AMR, active and chronic active but over time this classification has become increasingly complex. To simplify the approach to AMR, we developed activity and chronicity indices based on kidney transplant biopsy findings and examined their association with graft survival in 147 patients with active or chronic active AMR, all of whom had donor-specific antibodies and were treated for AMR. The activity index was determined as the sum of Banff glomerulitis (g), peritubular capillaritis (ptc), arteritis (v) and C4d scores, with a maximum score of 12. The chronicity index was the sum of interstitial fibrosis (ci), tubular atrophy (ct), chronic vasculopathy (cv), and chronic glomerulopathy (cg) scores, the latter doubled, with a maximum score of 15. While the activity index was generally not associated with graft loss, the chronicity index was significantly associated with graft loss with an optimal threshold value of 4 or greater for predicting graft loss. The association of the chronicity index of 4 or greater with graft loss was independent of other parameters associated with graft loss, including the estimated glomerular filtration rate at the time of biopsy, chronic active (versus active) AMR, AMR with de novo (versus persistent/rebound) donor-specific antibodies, Banff (g+ptc) scores, concurrent T cell-mediated rejection and donor-specific antibody reduction post-biopsy. The association of the chronicity index of 4 or greater with graft loss was confirmed in an independent cohort of 61 patients from Necker Hospital, Paris. Thus, our findings suggest that the chronicity index may be valuable as a simplified approach to decision-making in patients with AMR.
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