Umar Farooq Khan, Saeed Alam, Nasira Bhatti, Naureen Umar Barki, Fareeha Usman, Tasneem Akhtar Bhatti, Tahira Khalid.
Application of Banff Criteria on Cases of Acute Renal Transplant Rejection.
J Rawal Med Coll Jan ;4(1-2):24-6.

Introduction: Renal transplantation has changed the outlook of patients with end stage renal disease, and has emerged as the most suitable method of treatment. The first renal transplant was performed between monozygotic twins in 1954, because one of the brothers was suffering from chronic renal failure. The kidney allografts can be damaged by activation of the immune response, both cellular and humoral. The hyperacute rejection occurs when the recipient is previously sensitized to the antigens in graft. This type of rejection occurs in minutes to hours after transplantation. The acute rejection may occur at any time. It may be vascular and interstitial or cellular. In the Banff Scheme, these two types of rejections are considered under the heading of acute rejection. The tubulitis and intimal arteritis are regarded as the principal lesions indicative of acute rejections and they can be divided into grades of severity i.e. from grade I to III. The purpose of the present study was to study the cases of acute renal transplant rejection by applying Banff Criteria. Study: Renal biopsy specimens from 12 cases of acute renal transplant rejection were evaluated using Banff Criteria. Amongst glomerular changes, mesangial proliferation was the commonest finding (50%), followed by glomerulitis (25%) and fibrin thrombi (8.3%), respectively. Tubular changes included mild tubular necrosis (25%) and mild tubulitis (83.3%). In the interstitium, mild oedema was observed in 83.3% and mild inflammation in 75% of cases. According to Banff Criteria, borderline changes were seen in 8.3%, grade 1 changes in 83.3%, and grade 2 changes in 8.3% of cases.

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