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The Banff 2015 Kidney Meeting Report: Current Challenges in Rejection Classification and Prospects for Adopting Molecular Pathology.

Authors :
Loupy A
Haas M
Solez K
Racusen L
Glotz D
Seron D
Nankivell BJ
Colvin RB
Afrouzian M
Akalin E
Alachkar N
Bagnasco S
Becker JU
Cornell L
Drachenberg C
Dragun D
de Kort H
Gibson IW
Kraus ES
Lefaucheur C
Legendre C
Liapis H
Muthukumar T
Nickeleit V
Orandi B
Park W
Rabant M
Randhawa P
Reed EF
Roufosse C
Seshan SV
Sis B
Singh HK
Schinstock C
Tambur A
Zeevi A
Mengel M
Source :
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2017 Jan; Vol. 17 (1), pp. 28-41.
Publication Year :
2017

Abstract

The XIII Banff meeting, held in conjunction the Canadian Society of Transplantation in Vancouver, Canada, reviewed the clinical impact of updates of C4d-negative antibody-mediated rejection (ABMR) from the 2013 meeting, reports from active Banff Working Groups, the relationships of donor-specific antibody tests (anti-HLA and non-HLA) with transplant histopathology, and questions of molecular transplant diagnostics. The use of transcriptome gene sets, their resultant diagnostic classifiers, or common key genes to supplement the diagnosis and classification of rejection requires further consensus agreement and validation in biopsies. Newly introduced concepts include the i-IFTA score, comprising inflammation within areas of fibrosis and atrophy and acceptance of transplant arteriolopathy within the descriptions of chronic active T cell-mediated rejection (TCMR) or chronic ABMR. The pattern of mixed TCMR and ABMR was increasingly recognized. This report also includes improved definitions of TCMR and ABMR in pancreas transplants with specification of vascular lesions and prospects for defining a vascularized composite allograft rejection classification. The goal of the Banff process is ongoing integration of advances in histologic, serologic, and molecular diagnostic techniques to produce a consensus-based reporting system that offers precise composite scores, accurate routine diagnostics, and applicability to next-generation clinical trials.<br /> (© 2016 The Authors. American Journal of Transplantation published by Wiley Periodicals, Inc. on behalf of American Society of Transplant Surgeons.)

Details

Language :
English
ISSN :
1600-6143
Volume :
17
Issue :
1
Database :
MEDLINE
Journal :
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
Publication Type :
Academic Journal
Accession number :
27862883
Full Text :
https://doi.org/10.1111/ajt.14107