@article{6b675841be1d47b3b44685ea1ffd41f3,
title = "Reliability of deceased-donor procurement kidney biopsy images uploaded in United Network for Organ Sharing",
abstract = "Prior studies demonstrate poor agreement among pathologists{\textquoteright} interpretation of kidney biopsy slides. Reliability of representative images of these slides uploaded to the United Network of Organ Sharing (UNOS) web portal for clinician review has not been studied. We hypothesized high agreement among pathologists{\textquoteright} image interpretation, since static images eliminate variation induced by viewing different areas of movable slides. To test our hypothesis, we compared the assessments of UNOS-uploaded images recorded in standardized forms by three pathologists. We selected 100 image sets, each having at least two images from kidneys of deceased donors. Weighted Cohen's kappa was used for inter-rater agreement. Mean (SD) donor age was 50 (13). Acute tubular injury had kappas of 0.12, 0.14, and 0.19; arteriolar hyalinosis 0.16, 0.27, and 0.38; interstitial inflammation 0.30, 0.33, and 0.49; interstitial fibrosis 0.28, 0.32, and 0.67; arterial intimal fibrosis 0.34, 0.42, and 0.59; tubular atrophy 0.35, 0.41, and 0.52; glomeruli thrombi 0.32, 0.53, and 0.85; and global glomerulosclerosis 0.68, 0.70, and 0.77. Pathologists{\textquoteright} agreement demonstrated kappas of 0.12 to 0.77. The lower values raise concern about the reliability of using images. Although further research is needed to understand how uploaded images are used clinically, the field may consider higher-quality standards for biopsy photomicrographs.",
keywords = "agreement, biopsy, deceased donor, images, kappa, pathologists, renal, transplant",
author = "Mansour, {Sherry G.} and Hall, {Isaac E.} and Reese, {Peter P.} and Yaqi Jia and Heather Thiessen-Philbrook and Gilbert Moeckel and Weng, {Francis L.} and Revelo, {Monica P.} and Khalighi, {Mazdak A.} and Anshu Trivedi and Doshi, {Mona D.} and Bernd Schr{\"o}ppel and Parikh, {Chirag R.}",
note = "Funding Information: Our work was sustained and supported by 1) the National Institutes of Health, grant R01DK‐93770, grant K24DK090203, P30 DK 079310‐07, 3) a career development award from the American Heart Association to Dr. Hall, and 4) the Health Resources and Services Administration contract 234‐2005‐37011C. Funded by the American Heart Association Career Development, grant 18CDA34110151 (Dr. Sherry Mansour). Funding Information: Funding information Our work was sustained and supported by 1) the National Institutes of Health, grant R01DK-93770, grant K24DK090203, P30 DK 079310-07, 3) a career development award from the American Heart Association to Dr. Hall, and 4) the Health Resources and Services Administration contract 234-2005-37011C. Funded by the American Heart Association Career Development, grant 18CDA34110151 (Dr. Sherry Mansour). We are tremendously grateful for the study participation of our collaborators at the following organ procurement organizations: Gift of Life Philadelphia, New York Organ Donor Network, Michigan Organ and Tissue Donation Program, New Jersey Sharing Network, and New England Organ Bank. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government. These organizations were not involved in study design, analysis, interpretation, or manuscript creation. The data reported here have been supplied by the United Network for Organ Sharing (UNOS) as the contractor for the Organ Procurement and Transplantation Network (OPTN). The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy of or interpretation by the OPTN or the US Government. Publisher Copyright: {\textcopyright} 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd",
year = "2018",
month = dec,
doi = "10.1111/ctr.13441",
language = "English",
volume = "32",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "12",
}