August 14, 2011

Pathologic Interpretation of Transbronchial Biopsy for Acute Rejection of Lung Allograft is Highly Variable


Warning: Invalid argument supplied for foreach() in /nfs/c04/h03/mnt/65750/domains/transplantnow.com/html/wp-content/themes/nephrology/scripts/pubmed.php on line 177

Warning: Invalid argument supplied for foreach() in /nfs/c04/h03/mnt/65750/domains/transplantnow.com/html/wp-content/themes/nephrology/scripts/pubmed.php on line 177

Warning: Invalid argument supplied for foreach() in /nfs/c04/h03/mnt/65750/domains/transplantnow.com/html/wp-content/themes/nephrology/scripts/pubmed.php on line 177
.   .   

Acute cellular rejection is typically diagnosed by histopathologic examination of transbronchial lung biopsies.  Pathologic grading of acute rejection has been standardized, however interobserver variability for the grading has not been adequately determined. A blinded panel of pathologists regraded 1566 biopsies from 845 lung transplant recipients enrolled in the Lung Allograft Rejection Gene Expression Observational study.  Their interpretation was compared to the original diagnosis and grade of acute rejection determined by the individual center’s pathologists.  A high degree of variability was noted, with a kappa value for interobserver agreement of only 0.183 for A grade interpretation and only 0.035 for B grade interpretation.  With such high reader variability, histopathologic diagnosis may not be the ideal “gold standard” for acute cellular rejection in lung transplantation.

Lung Transplantation

Tags: , ,