TABLE 7.
Effect of considering model 2 regression scores on interpretation of biopsies with no Banff histology rejection (biopsies with BK removed)
Recorded histology and molecular features in 887 biopsies with no rejection by Banff guidelines | Regression diagnoses | |||
---|---|---|---|---|
No rejection (N = 827) | TCMR (N = 2) | Mixed (N = 3) | AMR (N = 55) | |
Histology lesion scores, plus DSA and C4d | ||||
TCMR-related | ||||
t (tubulitis) | 0.11 | 2.00 c | 2.67 c | 0.23 a |
i (interstitial infiltrate) | 0.22 | 2.00 c | 3.00 c | 0.73 c |
All rejection–related | ||||
v (vasculitis) | 0.00 | 0.00 | 0.00 | 0.04 c |
AMR-related | ||||
g (glomerulitis) | 0.11 | 0.00 | 0.50 | 1.51 c |
ptc (capillaritis) | 0.08 | 0.00 | 3.00 c | 1.04 c |
cg (double contours) | 0.05 | 0.00 | 0.00 | 1.02 c |
Atrophy-fibrosis-related | ||||
ci (scarring) | 1.06 | 2.50 a | 1.67 | 1.51 c |
ct (atrophy) | 1.00 | 2.50 | 1.67 | 1.27 |
DSA-related | ||||
DSA positivity | 0.35 | 0.00 | 0.00 | 0.32 |
C4d-related | ||||
C4d positivity | 0.06 | – | 0.50 a | 0.14 |
Transcript set and molecular classifier scores | ||||
TCMR-related classifiers | ||||
TCMR classifier (TCMRProb) | 0.04 | 0.21 a | 0.22 b | 0.04 a |
All rejection–related | ||||
Rejection classifier (RejProb) | 0.15 | 0.33 | 0.61 a | 0.45 c |
IFNG-inducible (GRIT3) | 0.39 | 0.87 a | 1.18 b | 0.65 c |
AMR-related | ||||
DSA-selective (DSAST) | 0.09 | 0.04 | 0.20 | 0.39 c |
NK cell burden (NKB) | 0.40 | 0.60 | 0.83 a | 0.87 c |
AMRd classifier (ABMRProb) | 0.10 | 0.06 | 0.08 | 0.32 c |
Wilcoxon test compared with the no-rejection group (significant values are bolded):
aP < 0.05;
bP < 0.01;
cP < 0.001.
dAMR is used throughout this article per journal style; however, the official classifier name is provided in this table.
AMR, antibody-mediated rejection; BK, polyoma virus; DSA, donor-specific antibody; IFNG, interferon gamma; TCMR, T-cell–mediated rejection.