Borderline T-Cell Mediated Rejection | Banff & Beyond

Welcome to the second episode of Banff and Beyond as we begin to discuss transplant cases and dive into the world of transplant rejection. The patient is a 45 y/o male status-post transplant who presents with elevated creatinine. The biopsy demonstrates features compatible with borderline T-cell mediated rejection as it shows interstitial inflammation comprising approximately 10-15% of the unscarred cortex (Banff score: I1) along with mild lymphocytic tubulitis within non-atrophic tubules (Banff score: T1). Of note, tubulitis is ideally graded in tubules cut in cross-section. However, if a longitudinally cut tubule is used, it is scored as the number of mononuclear cells per ten tubular epithelial cells. Additionally, one should not evaluate severely atrophic tubules when assessing for tubulitis including those with endocrine type atrophy, a diameter of less than 25% of the unaffected tubules, and those with pronounced basement membrane wrinkling or thickening.

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Excellent tutorial. Please, keep up the great work.
Greetings from Egypt.
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