biostudies-literatureUnknown40(2)Weidmann LUSZ FoundationBaugarten FoundationSwissLife Foundation<h4>Background</h4>Isolated tubulitis, borderline changes and isolated arteritis suspicious for histologic T-cell-mediated rejection (hTCMR) remain findings of uncertain significance. Although the Molecular Microscope Diagnostics System (MMDx) has not been trained on those lesions, it was suggested that MMDx might reclassify a subgroup to molecular TCMR (mTCMR).<h4>Methods</h4>In this single-center cohort of 326 consecutive, unselected kidney allograft biopsies assessed by histology and MMDx, we analyzed 249 cases with isolated tubulitis (i0, t1-3, v0; n = 101), borderline changes (according to Banff 2022, v0; n = 9), isolated arteritis (no borderline, v1; n = 37), no inflammation (i0, t0, v0; n = 67) and a positive control cohort (hTCMR, n = 27; mixed histologic rejection, n = 8; both accNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association294-307https://www.ebi.ac.uk/biostudies/studies/S-EPMC11852332biostudies-literatureLimitations of biopsy-based transcript diagnostics to detect T-cell-mediated allograft rejection.PMC11852332von Moos SHelmchen BMWeidmann LKorach RSchachtner TCastrezana Lopez KRho EHarmacek DGaspert ASchmid NBortel NfalseLimitations of biopsy-based transcript diagnostics to detect T-cell-mediated allograft rejection.<h4>Background</h4>Isolated tubulitis, borderline changes and isolated arteritis suspicious for histologic T-cell-mediated rejection (hTCMR) remain findings of uncertain significance. Although the Molecular Microscope Diagnostics System (MMDx) has not been trained on those lesions, it was suggested that MMDx might reclassify a subgroup to molecular TCMR (mTCMR).<h4>Methods</h4>In this single-center cohort of 326 consecutive, unselected kidney allograft biopsies assessed by histology and MMDx, we analyzed 249 cases with isolated tubulitis (i0, t1-3, v0; n = 101), borderline changes (according to Banff 2022, v0; n = 9), isolated arteritis (no borderline, v1; n = 37), no inflammation (i0, t0, v0; n = 67) and a positive control cohort (hTCMR, n = 27; mixed histologic rejection, n = 8; both acc2025-01-01T00:00:00Z2025 Feb2025-04-05T14:39:22.6Z2025-04-05T14:39:22.6ZS-EPMC118523323892565110.1093/ndt/gfae147