Banff, Alberta, Canada
August 9-14, 2009
Rimrock Resort Hotel
10th Banff Conference on Allograft Pathology

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Banff  2009 Online Virtual Slide Test on Renal Allograft Pathology

Click here to view the PowerPoint Presentation for the Friday presentation on Virtual microscopy as a tool for QA in Transplantation Pathology.

Quality assurance, quality control, and quality improvement are crucial concepts in transplantation pathology to ensure patient safety. Assessment of the quality of the final report is a major responsibility of the pathologist who renders the diagnosis. Starting this year, quality assurance/improvement and proficiency testing will be part of the Banff Conference on Allograft Pathology.

This online virtual slide test is designed to test the overall proficiency and diagnostic skills of practicing pathologists and trainees in reaching an accurate diagnosis in renal allograft biopsies and consistency of application of the Banff classification and lesion scores.

The results of the test will be presented and discussed at the 10th Banff Conference on Allograft Pathology. The test includes 5 biopsies with 3 virtual slides (H&E, PAS, Masson’s trichrome) per case. A brief clinical history for each case is given below. To view the virtual slides, click the link below:

http://allograftpath.upmc.com/home.aspx?u=Banff%202009

To see the images, you need an internet browser and Java runtime version 1.6 installed on your computer. A common username and password will be distributed to the attendees by e-mail. The test is also open to pathologists and trainees who are not able to attend the 10th Banff Conference on Allograft Pathology. To receive the username and password, please e-mail to bsis@ualberta.ca

Please download the blank answer sheet and complete for each case. Do not include your name on answer sheets. Submit your completed answer sheets via e-mail to mhaas@jhmi.edu and bsis@ualberta.ca by June 15, 2009.

We hope you enjoy the test and reading virtual slides!

 

Mark Haas, MD                                   Banu Sis, MD

 

Clinical Histories

Case 1: The patient is a 40-year- old man who received a renal transplant from a living related donor four months ago. Baseline serum creatinine was 130 µmol/L (1.47 mg/dL) but has been recently unstable over 200 µmol/L (2.26 mg/dL). A renal allograft biopsy is obtained to explain the unstable renal function. C4d immunofluorescence staining is negative.

Case 2:  The patient is a 67-year-old man who received a renal transplant from a living unrelated donor 14 months ago. Now presents with a rapid deterioration in renal function. B cell crossmatch is positive and the patient has circulating class II panel reactive antibodies at time of biopsy. A renal allograft biopsy is taken. Immunofluorescence shows diffuse C4d staining along peritubular capillaries.

Case 3: The patient is a 39-year-old man, status post living-related renal transplant 3 years ago. The patient is highly sensitized. Baseline serum creatinine has ranged between 1.4 and 1.7 mg/dL. His serum creatinine has recently increased to 2.7 mg/dL.  A renal allograft biopsy is performed. By immunofluorescence, C4d shows diffuse peritubular capillary staining.

Case 4: The patient is a 55-year-old man, status post living-related renal transplant 10 years ago. He has bipolar disorder. He is now presenting with deterioration in renal function with increased serum creatinine of 184 µmol/L (2.08 mg/dL). A renal allograft biopsy is performed. C4d immunofluorescence staining is negative.

Case 5: The patient is a 42-year-old man, status post positive crossmatch renal transplant 4 months ago. He now presents with a serum creatinine of 1.4 mg/dL, up from a baseline of 1.0 mg/dL. A renal allograft biopsy is performed. C4d immunofluorescence staining is negative in peritubular capillaries.

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