Concordance among pathologists in the second Cardiac Allograft Rejection Gene Expression Observational Study (CARGO II).
Transplantation
; 94(11): 1172-7, 2012 Dec 15.
Article
em En
| MEDLINE
| ID: mdl-23222738
ABSTRACT
BACKGROUND:
There has been no large evaluation of the ISHLT 2004 acute cellular rejection grading scheme for heart graft endomyocardial biopsy specimens (EMBs).METHODS:
We evaluated agreement within the CARGO II pathology panel and between the panel (acting by majority) and the collaborating centers (treated as a single entity), regarding the ISHLT grades of 937 EMBs (with all grades ≥2R merged because of small numbers).RESULTS:
Overall all-grade agreement was almost 71% both within the panel and between the panel and the collaborating centers but, in both cases, was largely because of agreement on grade 0 for the average pair of pathologists, fewer than a third of the EMBs assigned grade ≥2R by at least one were assigned this grade by both.CONCLUSION:
The 2004 revision has done little to improve agreement on the higher ISHLT grades. An EMB grade ≥2R is not by itself sufficient as a basis for clinical decisions or as a research criterion. Steps should be taken toward greater uniformity in EMB grading, and efforts should be made to replace the ISHLT classification with diagnostic criteria--EMB based or otherwise--that correspond better with the pathophysiology of the transplanted heart.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Patologia Clínica
/
Transplante de Coração
/
Rejeição de Enxerto
Tipo de estudo:
Clinical_trials
/
Evaluation_studies
/
Observational_studies
/
Prognostic_studies
Limite:
Humans
País/Região como assunto:
America do norte
/
Europa
Idioma:
En
Revista:
Transplantation
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Espanha