The 1991 Banff Working Classification for renal transplant pathology listed criteria for the histopathologic criteria for the diagnosis of chronic allograft nephropathy. The findings are nonspecific but feature interstitial fibrosis and tubular atrophy. The working classification was formulated by an international group of nephrologists, renal transplant surgeons and renal pathologists.
Parameters:
(1) chronic transplant glomerulopathy (cg)
(2) interstitial fibrosis with or without mononuclear cell inflammation (ci)
(3) tubular atrophy and loss (ct)
(4) fibrous intimal thickening with or without elastica fragmentation (cv)
Parameter |
Finding |
Code |
chronic transplant glomerulopathy (cg) |
none |
cg0 |
|
mild |
cg1 |
|
moderate |
cg2 |
|
severe |
cg3 |
interstitial fibrosis with or without mononuclear cell inflammation (ci) |
none |
ci0 |
|
mild |
ci1 |
|
moderate |
ci2 |
|
severe |
ci3 |
tubular atrophy and loss (ct) |
none |
ct0 |
|
mild |
ct1 |
|
moderate |
ct2 |
|
severe |
ct3 |
fibrous intimal thickening with or without elastica fragmentation (cv) |
none |
cv0 |
|
mild |
cv1 |
|
moderate |
cv2 |
|
severe (complete occlusion) |
cv3 |
where:
• Chronic transplant glomerulopathy (Table 4, page 415) shows mesangial cell proliferation, peripheral mesangial interposition, and sometimes cellular crescents. This is often accompanied by marked proteinuria.
Histologic Severity of Chronic Allograft Nephropathy |
Grade |
mild interstitial fibrosis and tubular atrophy |
Grade I |
moderate interstitial fibrosis and tubular atrophy |
Grade II |
severe interstitial fibrosis and tubular atrophy |
Grade III |
Features suggesting rejection:
(1) new-onset arterial fibrous intimal thickening
(2) glomerulopathy more severe than other parameters
Specialty: Nephrology, Clinical Laboratory
ICD-10: ,