Scholarlink

Purpose of Review <p>This review explores the ongoing challenges in standardizing pre-transplant kidney biopsy (PTRB) interpretation. It evaluates current scoring systems, technical limitations, and emerging tools aimed at improving the consistency of kidney assessment and utilization.</p> Recent Findings <p>PTRB interpretation is highly variable due to inconsistent histologic scoring systems—such as the Remuzzi, Karpinski, Maryland Aggregate Pathology Index, and Banff adaptations—and significant interobserver variability. Additional variability arises across organ procurement organizations (OPOs), which differ in their criteria for when to perform biopsies and how to act on the results. Protocols for biopsy interpretation and discard decisions are not standardized, leading to inconsistent kidney utilization. Technical limitations, such as frozen section artifacts and scanner variability in digital pathology, further exacerbate these discrepancies. Emerging solutions include AI-assisted image analysis, portable scanner technologies, and standardized digital workflows.</p> Summary <p>PTRBs are critical for donor kidney evaluation but lack uniformity across institutions and OPOs. Standardized scoring, AI integration, and national consensus on biopsy and discard protocols are essential to improve organ allocation and transplant outcomes.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Standardization of Pre-Transplant Kidney Biopsy Interpretation

  • 期刊论文

  • 发表日期：

    2025年6月13日

查看全文
  • Hussien Alasi,
  • Bryan J. Dangott,
  • Aziza Nassar,
  • Zeynettin Akkus,
  • Fadi Salem

摘要

Purpose of Review

This review explores the ongoing challenges in standardizing pre-transplant kidney biopsy (PTRB) interpretation. It evaluates current scoring systems, technical limitations, and emerging tools aimed at improving the consistency of kidney assessment and utilization.

Recent Findings

PTRB interpretation is highly variable due to inconsistent histologic scoring systems—such as the Remuzzi, Karpinski, Maryland Aggregate Pathology Index, and Banff adaptations—and significant interobserver variability. Additional variability arises across organ procurement organizations (OPOs), which differ in their criteria for when to perform biopsies and how to act on the results. Protocols for biopsy interpretation and discard decisions are not standardized, leading to inconsistent kidney utilization. Technical limitations, such as frozen section artifacts and scanner variability in digital pathology, further exacerbate these discrepancies. Emerging solutions include AI-assisted image analysis, portable scanner technologies, and standardized digital workflows.

Summary

PTRBs are critical for donor kidney evaluation but lack uniformity across institutions and OPOs. Standardized scoring, AI integration, and national consensus on biopsy and discard protocols are essential to improve organ allocation and transplant outcomes.