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Background. There has been no large evaluation of the ISHLT 2004 acute cellular rejection grading scheme for heart graft endomyocardial biopsy specimens (EMBs). Methods. We evaluated agreement within the CARGO II pathology panel and between the panel (acting by majority) and the collaborating centers (treated as a single entity), regarding the ISHLT grades of 937 EMBs (with all grades >2R merged because of small numbers). Results. Overall all-grade agreement was almost 71% both within the panel and between the panel and the collaborating centers but, in both cases, was largely because of agreement on grade 0: for the average pair of pathologists, fewer than a third of the EMBs assigned grade >2R by at least one were assigned this grade by both. Conclusion. The 2004 revision has done little to improve agreement on the higher ISHLT grades. An EMB grade >2R is not by itself sufficient as a basis for clinical decisions or as a research criterion. Steps should be taken toward greater uniformity in EMB grading, and efforts should be made to replace the ISHLT classification with diagnostic criteria—EMB based or otherwise—that correspond better with the pathophysiology of the transplanted heart.

Titel:	Concordance Among Pathologists in the Second Cardiac Allograft Rejection Gene Expression Observational Study (CARGO II)
Autor/in / Beteiligte Person:	CRESPO-LEIRO, Maria G ; ZUCKERMANN, Andreas ; STYPMANN, Joerg ; HOEFER, Daniel ; LEHMKUHL, Hans ; DENG, Mario C ; LEPRINCE, Pascal ; BERRY, Gerald ; MARBOE, Charles C ; STEWART, Susan ; TAZELAAR, Henry D ; BARON, Helen M ; BARA, Christoph ; COLEMAN, Ian-Charles ; VANHAECKE, Johan ; MOHACSI, Paul ; SCHULZ, Uwe ; BOYLE, Andrew ; ROSS, Heather J ; PARAMESHWAR, Jayan ; ZAKLICZYNSKI, Michael ; FIOCCHI, Roberto
Link:	Full Text Finder (Volltext) View record from PASCAL Archive
Zeitschrift:	Transplantation, Jg. 94 (2012), Heft 11, S. 1172-1177
Veröffentlichung:	Hagerstown, MD: Lippincott Williams & Wilkins, 2012
Medientyp:	academicJournal
Umfang:	print, 19 ref
ISSN:	0041-1337 (print)
Schlagwort:	Graft, transplantation Greffe, transplantation Sciences biologiques et medicales Biological and medical sciences Sciences biologiques fondamentales et appliquees. Psychologie Fundamental and applied biological sciences. Psychology Immunologie fondamentale Fundamental immunology Immunologie de tissu, d'organe, des greffes Tissue, organ and graft immunology Sciences medicales Medical sciences Chirurgie (generalites). Transplantations, greffes d'organes et de tissus. Pathologie des greffons Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Appareil circulatoire Circulatory system Aparato circulatorio Chirurgie Surgery Cirugía Transplantation Trasplantación Coeur Heart Corazón Concordance Concordancia Etude observationnelle Observational study Estudio observacional Expression génique Gene expression Expresión genética Greffe Graft Injerto Greffon Graft(material) Injerto(material) Homotransplantation Homotrasplante Rejet Rejection Rechazo Traitement Treatment Tratamiento
Sonstiges:	Nachgewiesen in: PASCAL Archive Sprachen: English Original Material: INIST-CNRS Document Type: Article File Description: text Language: English Author Affiliations: Unidad de Insuficiencia Cardiaca Avanzada y Trasplante Cardiaco, Hospital Universitario A Coruna, La Coruna, Spain ; Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria ; Department of Cardiovascular Medicine, Division of Cardiology, University Hospital Miinster, Miinster, Germany ; Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria ; Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum, Berlin, Germany ; College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, United States ; Department of Cardiothoracic Surgery, Groupe Hospitalier Pitié-Salpêtrière, Paris, France ; Department of Pathology, Stanford University Medical Center, Palo Alto, CA, United States ; Papworth Hospital, Papworth Everard, Cambridge, United Kingdom ; Department of Laboratory Medicine and Pathology, Mayo Clinic, Scottsdale, Azerbaijan ; XDx Inc, Brisbane, CA, United States ; Department of Cardiovascular, Thoracic, and Transplant Surgery, Hannover Medical School, Hannover, Germany ; Cardiovascular Diseases, University Hospitals Leuven, & Department of Cardiovascular Sciences, KU Leuven, Belgium ; Department of Cardiology, Swiss Cardiovascular Centre Bern, University Hospital Bern, Bern, Switzerland ; Heart Center North Rhine-Westphalia, Department of Thoracic and Cardiovascular Surgery, Ruhr University of Bochum, Bad Oeynhausen, Germany ; Division of Cardiothoracic Surgery, University of Minnesota, Minneapolis, MN, United States ; Division of Cardiology and Heart Transplantation, Toronto General Hospital, Toronto, Canada ; Department of Cardiac Surgery & Transplantation, Silesian Center for Heart Disease, Zabrze, Poland ; Cardiovascular Department-Transplant Section, Ospedali Riuniti di Bergamo, Bergamo, Italy Rights: Copyright 2014 INIST-CNRS ; CC BY 4.0 ; Sauf mention contraire ci-dessus, le contenu de cette notice bibliographique peut être utilisé dans le cadre d’une licence CC BY 4.0 Inist-CNRS / Unless otherwise stated above, the content of this bibliographic record may be used under a CC BY 4.0 licence by Inist-CNRS / A menos que se haya señalado antes, el contenido de este registro bibliográfico puede ser utilizado al amparo de una licencia CC BY 4.0 Inist-CNRS Notes: Fundamental immunology ; Surgery (generalities). Transplants, organs and tissues grafting. Graft pathologies

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Concordance Among Pathologists in the Second Cardiac Allograft Rejection Gene Expression Observational Study (CARGO II)