Revision of the 1990 Working Formulation for the Standardization of Nomenclature in the Diagnosis of Heart Rejection

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Published 1 November 2005

Susan Stewart; Gayle L. Winters, MD; Michael C. Fishbein, MD; Henry D. Tazelaar, MD; Jon Kobashigawa, MD; Jacki Abrams, MD; Claus B. Andersen, MD, DMSc; Annalisa Angelini, MD; Gerald J. Berry, MD; Margaret M. Burke; Anthony J. Demetris, MD; Elizabeth Hammond, MD; Silviu Itescu, MD; Charles C. Marboe, MD; Bruce McManus, MD, PhD; Elaine F. Reed, PhD; Nancy L. Reinsmoen, PhD; E. Rene Rodriguez, MD; Alan G. Rose, MD; Marlene Rose, PhD, MRCPath; Nicole Suciu-Focia, PhD; Adriana Zeevi, PhD; Margaret E. Billingham

J Heart Lung Transplant 2005 Nov;24(11):1710-20

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  • Standards Statement

In 1990, an international grading system for cardiac allograft biopsies was adopted by the International Society for Heart Transplantation. This system has served the heart transplant community well, facilitating communication between transplant centers, especially with regard to patient management and research. In 2004, under the direction of the International Society for Heart and Lung Transplantation (ISHLT), a multidisciplinary review of the cardiac biopsy grading system was undertaken to address challenges and inconsistencies in its use and to address recent advances in the knowledge of antibody-mediated rejection.

In 2004, again under the direction of the ISHLT, a multidisciplinary review of the cardiac biopsy grading system was undertaken with task forces examining the areas of histopathology/cellular rejection, humoral (antibody-mediated) rejection, clinical issues and future research. In addition, comments solicited from the ISHLT membership at large were taken into account, which mainly concerned Grade 2 cellular rejection and humoral rejection. Consensus was reached and presented at the 24th Annual ISHLT scientific meeting. This article summarizes the revised consensus classification for cardiac allograft rejection.

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