1991 Banff Histopathologic Criteria for Chronic Allograft Nephropathy

Description

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

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Description

Specialty

ICD-10