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Review Article

J Korean Soc Transplant 2017; 31(4): 170-176

Published online December 31, 2017

https://doi.org/10.4285/jkstn.2017.31.4.170

© The Korean Society for Transplantation

Investigation and Standardization on Current Practice of Renal Transplant Pathology in Korea

Uiju Cho, M.D.1, Kwang Sun Suh, M.D.2, Jeong Hae Kie, M.D.3, Yeong Jin Choi, M.D.4 and Renal Pathology Study Group of Korean Society of Pathologists

Department of Pathology, St. Vincent’s Hospital, The Catholic University of Korea College of Medicine1, Suwon, Cancer Research Institute, Chungnam National University School of Medicine2, Daejeon, National Health Insurance Service Ilsan Hospital3, Goyang, Seoul St. Mary’s Hospital, The Catholic University of Korea College of Medicine4, Seoul, Korea

Correspondence to: Yeong Jin Choi
Department of Hospital Pathology, Seoul St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Banpo daero 222, Seocho-gu, Seoul 06591, Korea
Tel: 82-2-2258-1616, Fax: 82-2-2258-1628 E-mail: mdyjchoi@catholic.ac.kr

Received: December 13, 2017; Accepted: December 18, 2017

Abstract

We need to establish an informative guideline to increase inter-institutional and inter-observer reproducibility of renal transplant diagnosis, and to improve the diagnostic ability of pathologists in Korea. A first nation-wide survey for renal transplant pathology was conducted by Renal Pathology Study Group of the Korean Society of Pathologists in 2016, to provide the continued excellence in the transplantation pathology laboratory, and to improve the diagnostic ability for the best treatment of transplant patients. This survey revealed the significant variations in scale, work load and biopsy indications for the renal transplant pathology in various institutions in Korea. The Banff classification were used by all institutions for the diagnosis of renal transplant pathology, but different formats were used: most institutions (70%) used the “2013 Banff classification” while the others were using “2007 Banff classification” (20%) or even older formats. In daily diagnostic practice of the renal allografts, difficulties that pathologists encounter were quite diverse due to different environments they work in. Most respondents agreed that standardized diagnostic practice guidelines, regular education on renal transplant pathology and convenient ways of consultation are further needed. We are currently working toward the enhancement of the expertise of renal pathologists and to increase inter-institutional and inter-observer reproducibility by 1) development of a set of virtual slides of renal allograft biopsies for the training, 2) validation and gathering expert's consensus on the core variables of rejection diagnosis by using virtual slides, and 3) continued education by the developed virtual slide atlas.

Keywords: Kidney, Transplantation, Pathology, Diagnosis, Standardization