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

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 an...

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Veröffentlicht in:	American journal of transplantation Jg. 17; H. 1; S. 28 - 41
Hauptverfasser:	Loupy, A., Haas, M., Solez, K., Racusen, L., Glotz, D., Seron, D., Nankivell, B. J., Colvin, R. B., Afrouzian, M., Akalin, E., Alachkar, N., Bagnasco, S., Becker, J. U., Cornell, L., Drachenberg, C., Dragun, D., Kort, H., Gibson, I. W., Kraus, E. S., Lefaucheur, C., Legendre, C., Liapis, H., Muthukumar, T., Nickeleit, V., Orandi, B., Park, W., Rabant, M., Randhawa, P., Reed, E. F., Roufosse, C., Seshan, S. V., Sis, B., Singh, H. K., Schinstock, C., Tambur, A., Zeevi, A., Mengel, M.
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	United States Elsevier Limited 01.01.2017 John Wiley and Sons Inc
Schlagworte:	Arteritis - immunology Atrophy Classification clinical research/practice Clinical trials Complement C4b - immunology Fibrosis Gene expression Graft rejection Graft Rejection - classification Graft Rejection - etiology Graft Rejection - pathology Histocompatibility antigen HLA Humans Isoantibodies - immunology Kidney Transplantation - adverse effects kidney transplantation/nephrology Kidney transplants Lymphocytes T Meeting Report Meeting Reports organ transplantation in general Pancreas transplantation Pathology pathology/histopathology Peptide Fragments - immunology rejection rejection: antibody‐mediated (ABMR) rejection: subclinical rejection: T cell mediated (TCMR) Research Report translational research/science Transplants & implants pathology/histopathology rejection: T cell mediated (TCMR) translational research/science organ transplantation in general clinical research/practice kidney transplantation/nephrology rejection: antibody-mediated (ABMR) rejection: subclinical rejection
ISSN:	1600-6135, 1600-6143, 1600-6143
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Zusammenfassung:	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. In this article, the Banff consortium presents the most updated version of the kidney, pancreas, and VCA transplant rejection classification and prospects for implementing intragraft molecular assessment. See the companion report on page 42.
Bibliographie:	Bruneval et al Both authors contributed equally. See also . ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 See also: Bruneval et al.
ISSN:	1600-6135 1600-6143 1600-6143
DOI:	10.1111/ajt.14107