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Reliability and predictive value of the National Institute of Diabetes and Digestive and Kidney Diseases Liver Transplantation Database nomenclature and grading system for cellular rejection of liver allografts by A. Jake Demetris; Eric C. Seaberg; Kenneth P. Batts; Linda D. Ferrell; Jurgen Ludwig; Rodney S. Markin; Steven H. Belle; Katherine Detre is a Medicine article available to read on EtoBox.

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Pathologists participating in the National Institute of Diabetes and Digestive and Kidney Diseases Liver Transplant Database (LTD) created a histopathological grading system for acute liver allograft rejection, and tested it first for inter-and intra-rater reliability among a group of five pathologists experienced in liver and transplantation pathology. Specimens from post-transplantation biopsies from 48 patients with rejection, hepatitis, or other diagnosis(es) were reviewed. There was moderate to good (kappa = 0.40 to 0.55) inter-rater and good (kappa = 0.55 to 0.58) intrarater agreement for the diagnosis and exact grading of mild, moderate, or severe acute rejection, which improved when a short clinical history was provided. Thus, the scheme was reproducible, and few of the disagreements among the pathologists would have affected treatment decisions. Secondly, the ability of the grading system to predict an unfavorable short-or long-term outcome from the initial histopathological diagnosis of cellular rejection was tested on groups of 168 and 133 patients, respectively, from the three LTD clinical centers, who were followed up for at least 6 months after the first onset of reje

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Author

A. Jake Demetris; Eric C. Seaberg; Kenneth P. Batts; Linda D. Ferrell; Jurgen Ludwig; Rodney S. Markin; Steven H. Belle; Katherine Detre

Publisher

Ovid Technologies (Wolters Kluwer Health)

Published

1995

Language

EN

Field

Medicine (Health Sciences)