Pathologic evaluation of pig kidney and heart xenografts: 2024 recommendations from the Banff Xenotransplantation Pathology Working Group

American Journal of Transplantation, vol. 26, pp. 1561–1576

Abstract

The purpose of this white paper is to recommend the minimum reporting standards for pathologic characterization of kidney and heart xenografts in humans. This proposal is based on the current human classifications for kidney and heart allografts, with additions and caveats relevant to xenografts that are primarily based on non-human primate and a limited number of organ xenografts in decedent and living humans. Such recommendations should not be regarded as diagnostic criteria, given that many new pathologic patterns and mechanisms remain to be fully characterized. While xenograft transplantation continues to evolve, this report serves as groundwork and an initial step towards defining international standards in xenograft histopathology assessment and reporting. Note: The authors welcome comments from the international transplantation community through the AJT Banff Blog: https://amjtransplant.wixsite.com/ajtbanffblog

Authors 24

1. Ivy A. Rosales corresponding

   Harvard University · Massachusetts General Hospital

   Affiliation as printed

   Department of Pathology, Immunopathology Research Laboratory, Massachusetts General Hospital, Boston, Massachusetts, USA. Electronic address: irosales@mgh.harvard.edu

2. Alton B. Farris

   Emory University

   Affiliation as printed

   Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, USA

3. Valentin Goutadier

   Inserm · Assistance Publique – Hôpitaux de Paris · Université Paris Cité · Hôpital Européen Georges-Pompidou · Centre d'Investigation Clinique Hôpital Européen Georges Pompidou

   Affiliation as printed

   Université Paris Cité, INSERM Unité 970, Paris Institute of Transplantation and Organ Regeneration, Paris, France; Clinical Investigation Center CIC1418, DMU CARTE, Georges Pompidou European Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France

4. Aurélie Sannier

   Inserm · Université Paris Cité

   Affiliation as printed

   Université Paris Cité, INSERM Unité 970, Paris Institute of Transplantation and Organ Regeneration, Paris, France

5. Huma Fatima

   University of Alabama at Birmingham · UAB Medicine

   Affiliation as printed

   Department of Pathology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA

6. Claire Trivin-Avillach

   Massachusetts General Hospital

   Affiliation as printed

   Department of Pathology, Immunopathology Research Laboratory, Massachusetts General Hospital, Boston, Massachusetts, USA

7. Fiorella Calabrese

   University of Padua

   Affiliation as printed

   Department of Cardiac, Thoracic, Vascular Science and Public Health, Università di Padova, Padua, Italy

8. Marian C. Clahsen‐van Groningen Aachen Department of Nephrology

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Nephrology, University Hospital RWTH Aachen, Aachen, Germany; Laboratory for Pathology (PAL), Dordrecht, The Netherlands

9. Emanuele Cozzi

   University of Padua · Azienda Ospedale - Università Padova

   Affiliation as printed

   Transplant Immunology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health Padua University Hospital, Padua, Italy

10. Carolyn L. Hodo

    The University of Texas MD Anderson Cancer Center

    Affiliation as printed

    Department of Comparative Medicine, The University of Texas MD Anderson Cancer Center, Bastrop, Texas, USA

11. Nicolas Kozakowski

    Medical University of Vienna

    Affiliation as printed

    Department of Pathology, Medical University of Vienna, Vienna, Austria

12. Jean Kwun

    Duke Medical Center · Duke University

    Affiliation as printed

    Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA

13. Greg Nowak

    Columbia University · Columbia University Irving Medical Center

    Affiliation as printed

    Columbia Center for Translational Immunology, Department of Medicine, Columbia University, New York, New York, USA

14. Gabriel C. Oniscu

    Karolinska Institutet

    Affiliation as printed

    Division of Transplantation Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden

15. Miroslav Sekulic

    Columbia University Irving Medical Center

    Affiliation as printed

    Department of Pathology, Columbia University Irving Medical Center, New York, New York, USA

16. Megan Sykes

    Columbia University · Columbia University Irving Medical Center

    Affiliation as printed

    Columbia Center for Translational Immunology, Department of Medicine, Columbia University, New York, New York, USA

17. Ming Ting Wu

    Northwell Health

    Affiliation as printed

    Department of Pathology, Northwell Health, New York, USA

18. Roslyn Bernstein Mannon

    University of Nebraska Medical Center

    Affiliation as printed

    Department of Internal Medicine, Division of Nephrology, University of Nebraska Medical Center, Omaha, Nebraska, USA

19. Alexandre Loupy

    Inserm · Université Paris Cité

    Affiliation as printed

    Université Paris Cité, INSERM Unité 970, Paris Institute of Transplantation and Organ Regeneration, Paris, France

20. Robert B. Colvin

    Massachusetts General Hospital

    Affiliation as printed

    Department of Pathology, Immunopathology Research Laboratory, Massachusetts General Hospital, Boston, Massachusetts, USA

21. Michael Mengel

    University of Alberta

    Affiliation as printed

    Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada

22. Cinthia B. Drachenberg

    University of Maryland, Baltimore

    Affiliation as printed

    Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA

23. Patrick Bruneval

    Inserm · Université Paris Cité

    Affiliation as printed

    Université Paris Cité, INSERM Unité 970, Paris Institute of Transplantation and Organ Regeneration, Paris, France

24. Ibrahim Batal

    Columbia University Irving Medical Center

    Affiliation as printed

    Department of Pathology, Columbia University Irving Medical Center, New York, New York, USA