International Grading Scheme for Acute Cellular Rejection in Small-Bowel Transplantation: Single-Center Experience

Phillip Ruiz, H. Takahashi, V. Delacruz, E. Island, Gennaro Selvaggi, Seigo Nishida, J. Moon, Lesley J Smith, T. Asaoka, D. Levi, Akin Tekin, A. G. Tzakis

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Abstract

A standardized grading scheme for the assessment of acute cellular rejection (ACR) in small-intestine transplantation was proposed in 2003 at the Eighth International Small Intestinal Transplantation Symposium. We have implemented the current grading scheme for ACR in small-bowel transplantation since October 2003. The pathologic diagnoses of those small-intestine biopsy samples, including ACR grade and other supplementary findings were evaluated. A total of 3484 small intestine biopsy samples from 155 patients were available for evaluation in this study. Frequency of grades 0, indeterminate, 1, 2, and 3 acute cellular rejection was 33.9%, 49.1%, 12.6%, 3.7%, and 0.8%, respectively. Duration of ACR episode strongly correlated with grade of ACR episode (P < .001). Other supplementary findings included acute vascular rejection component, 2.2%; increase in lymphoplasmacytic infiltrate in lamina propria, 15.7%; mucosal fibrosis, 0.4%; and regenerative changes, 0.3%. Our data substantiate that this grading system is reliable and useful for clinical decision making in bowel transplantation. We suggest that an assessment and quantification of supplementary findings be considered a component of the International Pathology Grading Scheme.

Original languageEnglish
Pages (from-to)47-53
Number of pages7
JournalTransplantation Proceedings
Volume42
Issue number1
DOIs
StatePublished - Jan 1 2010

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Transplantation
Small Intestine
Biopsy
Blood Vessels
Mucous Membrane
Fibrosis
Pathology

ASJC Scopus subject areas

  • Surgery
  • Transplantation

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International Grading Scheme for Acute Cellular Rejection in Small-Bowel Transplantation : Single-Center Experience. / Ruiz, Phillip; Takahashi, H.; Delacruz, V.; Island, E.; Selvaggi, Gennaro; Nishida, Seigo; Moon, J.; Smith, Lesley J; Asaoka, T.; Levi, D.; Tekin, Akin; Tzakis, A. G.

In: Transplantation Proceedings, Vol. 42, No. 1, 01.01.2010, p. 47-53.

Research output: Contribution to journalArticle

Ruiz, Phillip ; Takahashi, H. ; Delacruz, V. ; Island, E. ; Selvaggi, Gennaro ; Nishida, Seigo ; Moon, J. ; Smith, Lesley J ; Asaoka, T. ; Levi, D. ; Tekin, Akin ; Tzakis, A. G. / International Grading Scheme for Acute Cellular Rejection in Small-Bowel Transplantation : Single-Center Experience. In: Transplantation Proceedings. 2010 ; Vol. 42, No. 1. pp. 47-53.
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