| Specimen Adequacy (a necessary prerequisite for numeric coding) | |
|---|---|
| Unsatisfactory | No glomeruli or arteries |
| Marginal | 1-6 glomeruli with artery |
| Adequate | 7 or more glomeruli with artery | Minimum Sampling |
| 7 slides | 3 H&E, 3 PAS and 1 trichrome |
| Quantitative Criteria for Tubulitis ("t") Score (assumes minimum sampling) | |
|---|---|
| t0 | No mononuclear cells in tubules |
| t1 | Foci with 1 to 4 cells/tubular cross section or 10 tubular cells |
| t2 | Foci with 5 to 10 cells/tubular cross section |
| t3 | Foci with >10 cells/tubular cross section, or the presence of at least two areas of tubular basement membrane destruction accompanied by i2/i3 inflammation and t2 tubulitis elsewhere in the biopsy. |
| Quantitative Criteria for Mononuclear Cell Interstitial Inflammation ("i") | |
|---|---|
| i0 | No or trivial interstitial inflammation |
| i1 | Up to 25% of parenchyma inflamed cells |
| i2 | 26 to 50% of parenchyma inflamed |
| i3 | >50% of parenchyma inflamed |
| Quantitative Criteria for the Early Type of Allograft Glomerulitis ("g") | |
|---|---|
| g0 | No glomerulitis |
| g1 | Glomerulitis in a minority of glomeruli |
| g2 | Segmental or global glomerulitis in about 25 to 75% of glomeruli |
| g3 | Glomerulitis (mostly global) in all or almost all glomeruli |
| Quantitative Criteria for Arteriolar Hyaline Thickening ("ah") | |
|---|---|
| ah0 | No PAS-positive hyaline thickening |
| ah1 | Mild-to-moderate PAS-positive hyaline thickening in at least one arteriole |
| ah2 | Moderate-to-severe PAS-positive hyaline thickening in more than one arteriole |
| ah3 | Severe PAS-positive hyaline thickening in many arterioles |
| Quantitative Criteria for Intimal Arteritis ("v") | |
|---|---|
| v0 | No arteritis |
| v1 | Mild-to-moderate intimal arteritis in at least one arterial cross section |
| v2 | Moderate-to-severe intimal arteritis in more than one arterial cross section |
| v3 | Severe intimal arteritis in many arterial cross sections and/or "transmural" arteritis, fibrinoid change and medial smooth muscle necrosis, often with patchy infarction and interstitial hemorrhage |
| Quantitative Criteria for Allograft Glomerulopathy ("cg") | |
|---|---|
| cg0 | No glomerulopathy |
| cg1 | Mesangial matrix expansion and BM thickening, ± double contours, in capillary loops affecting up to 25% of nonsclerotic glomeruli |
| cg2 | Increasd severity of changes described above affecting 26 to 50% of nonsclerotic glomeruli |
| cg3 | Severe changes of classic transplant glomerulopathy affecting more than 50% of nonsclerotic glomeruli and with double contours in many capillary loops |
| Quantitative Criteria for Interstitial Fibrosis ("ci") | |
|---|---|
| ci0 | Interstitial fibrosis tissue in up to 5% of cortical area |
| ci1 | Mild Interstitial fibrosis tissue in 6 to 25% of cortical area |
| ci2 | Moderate interstitial fibrosis of 26 to 50% of cortical area |
| ci3 | Moderate interstitial fibrosis of >50% of cortical area |
| Quantitative Criteria for Tubular Atrophy ("ct") | |
|---|---|
| ct0 | No tubular atrophy |
| ct1 | Tubular atrophy in up to 25% of the area of cortical tubules |
| ct2 | Tubular atrophy involving 26 to 50% of the area of cortical tubules |
| ct3 | Tubular atrophy of >50% of the area of cortical tubules |
| Quantitative Criteria for Fibrous Intimal Thickening ("cv") | |
|---|---|
| cv0 | No chronic vascular changes |
| cv1 | Vascular narrowing of up to 25% lumenal area by fibrointimal thickening of arteries ± breach of internal elastic lamina or presence of foam cells or occasional mononuclear cells |
| cv2 | Increased severity of changes described above with 26 to 50% narrowing of vascular lumenal area |
| cv3 | Severe vascular changes with >50% narrowing of vascular lumenal area |
References
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