TABLE 1.
Rank ordered dd-cfDNA by percent, BK diagnosis, and concurrent pathology reports
| AlloSure % | Patient | BK PCR copies | BK diagnosis | Pathology report from concurrent biopsy | Rejection |
|---|---|---|---|---|---|
| 0.29 | 1 | 2100 | BK viremia | 2 globally sclerosed glomeruli, cd68(0-3), CD3(0), mononuclear infiltrate, 45% cortical scarring, SV40 positive, C4d negative, trichrome interstitial fibrosis and tubular atrophy | No acute rejection |
| 0.43 | 4 | 1500 | BK viremia | No sclerosed glomeruli, CD68(0-1) CD3(0-4), mononuclear infiltrate, severe tubulitis (ti2_, iatr3, I, t1, moderate IF/TA, arterial intimal fibrosis | No acute rejection |
| 0.43 | 5 | 4800 | BK viremia | No sclerosed glomeruli, CD68(0-1) CD3(0-4), no significant infiltrate, no tubulitis (ti, iatr3, i, t, tatr, ptc), mild sclerosis no arterial inflammation. C4d negative | No acute rejection |
| 0.58 | 7 | 7500 | BK viremia | 26 glomeruli/8 sclerosed, 5 with hyaline deposit, focal fibrosis −30% IF/TA, no tubulitis or capillaritis, C4d negative, SV40 negative, C3 2+ t0, v0, i1, g0, ci2, ct2, cg1b, mm, cv2, ah3, ptc0 | No acute rejection |
| 0.68 | 5 | 7700 | BK viremia | 22 glomeruli, non sclerosed. cd68(0-3), CD3(0-7) (g_cg_mm), minimal mononuclear infiltrate, multifocal IF/TA(15%) (ti_, iatr3, i_, t, tatr, ptc), no capillaritis/tubulitis. Arterioles mild hyalinosis (v_cv_ahl) SVC4d negative, decoy cells in urine | No rejection |
| 1.15 | 3 | 9800 | BK Viremia | Minimal inflammatory infiltrate, Mild IF/TA | Borderline T-cell–mediated rejection |
| 1.22 | 6 | 10 000 | BK viremia | No formal path report | Grade IA rejection |
| 1.77 | 7 | 37 100 | BKVAN | 4 unremarkable glomeruli. CD68 0, CD3 0-1 (g_cg_, mm), moderate inflammatory infiltrate. No capillaritis but multifocal tubulitis (ti3, iatr3, i3, t2, tatr3, ptc). Mild IF/TA. SV40 positive in 75% of biopsy. C4d negative, DSA DQ2 positive | No rejection |
| 2.3 | 5 | 68 100 | BKVAN | 6 glomeruli, CD68(1-8), CD3(0-2) (g_, cg_, mm_), dense mononuclear infiltrate, plasma cell stain for IgM, SV40 focally positive, moderate tubuliits, no capillaritis, mild IF/TA (ti1, iatr1, i1, t3, tatr_, ptc_)C4d negative. Urine with decoy cells | Grade IA ACR rejection |
| 2.31 | 8 | 150 300 | BKVAN | 37 glomeruli, none sclerosed, moderate infiltrate, C4d negative. severe IF/TA, extensive tubulitis, no arteritis or capillaritis t2, i3, g2 | Patient went to have grade IA rejection |
| 3.38 | 9 | 500 000 | BKVAN | 8 glomeruli, CD68(0-6), CD3(1-4) (g_, cg_, mm_)prominent inflammatory infiltrate, severe tubulitis, no capillaritis (ti3, iatr2, i2, t3, tatr3, ptc_)moderate focal IF/TA, scarring in 25% of cortex (ci, ct1) SV40positive, C4d negative | T-cell mediated rejection, type IB |
| 3.56 | 10 | 289 000 | BKVAN | No formal path report— Moderate IF/TA, t2, i2 | Rejection IA |
| 4.54 | 2 | 384 000 | BKVAN | No formal path report—Moderate IF/TA | Grade IIA rejection |
| 4.65 | 3 | 22 000 000 | BKVAN | 37 glomeruli/1 sclerosed, intimal arteritis, arteriolar hyaline deposit, focal fibrosis -moderate IF/TA, severe tubulitis,C4d negative, SV40 negative (i2-3, t3, ci1, ct2, cv0, cg0, ah2, ptc0) | Banff IB |
ah, arteriolar hyalinosis; aah, hyaline arteriolar thickening; BKVAN, BK virus–associated nephropathy; ci, interstitial fibrosis; ct, tubular atrophy; cv, vascular fibrous intimal thickening; dd-cfDNA, donor-derived cell-free DNA; i, interstitial inflammation; i-IFTA, inflammation in the area of IF/TA; iatr, inflammation in areas of tubular atrophy; IF/TA, interstitial fibrosis and tubular atrophy; g, glomerulitis; mm, mesangial matrix expansion; ptc, peritubular capillaritis; SV40, simian virus 40; t, tubilitis; tatr, tubulitis in areas of tubular atrophy; ti, total inflammation; v, initimal arteritis.