Banff Working Groups (BWGs)
Six BWGs aiming at
addressing unmet needs in transplantation pathology were established at the 10th
Banff Conference on Allograft Pathology
(Figure 1) and two more subsequently added. These
international BWGs will collect data on areas where Banff criteria are
problematic, work with multiple centers, validate the results, and ultimately
refine and improve the classification, thus ensuring that the Banff process is
evidence-based and continues to lead to improvements in patient care and
Transplant physicians from around the world are encouraged to participate in the BWGs.
T cell-mediated rejection BWG:
Aim: The Banff TCMR-Borderline Working Group seeks to re-evaluate the histologic phenotypes and clinical significance of pure acute T-cell mediated rejection (TCMR) and Banff category 3 “Borderline Changes” in the era of “C4d staining and routine DSA testing”. It will revisit current threshold levels for diagnosis of different types of rejection with special emphasis on previously published CCTT criteria and recommend whether any changes are needed or if incorporation of additional criteria might be helpful.
To participate, please contact either Volker Nickeleit, MD, firstname.lastname@example.org, or Parmjeet Randhawa, MD, email@example.com
Highly sensitized BWG:
Aim: The objective of the Highly Sensitized Working Group are: 1) To determine the definitions and practices of clinicians, tissue typing laboratory directors, and pathologists in evaluating and managing highly sensitized kidney transplant candidates and recipients; 2) To define criteria for enlistment criteria of subjects for studies; 3) To assess for differences in antibody-mediated rejection in highly sensitized patients versus other kidney transplant recipients; 4) To develop evidence-based recommendations for evaluation and transplantation of patients with broad sensitization and/or high titer donor-specific antibodies.
To participate, please contact Ed Kraus, MD firstname.lastname@example.org, Serena Bagnasco, MD, email@example.com, Lynn Cornell, MD, firstname.lastname@example.org, or Carrie Schinstock, MD, email@example.com
Isolated v-lesion BWG:
Aim: To address the significance of isolated v- lesions (with little or no tubulo-interstitial inflammation) in renal allograft biopsies. At present, 144 biopsies with isolated v-lesions have been collected from 7 centers. Work will soon commence comparing outcomes of patients with isolated v-lesions with control groups.
To participate, please contact Banu Sis, MD, FRCPC, firstname.lastname@example.org
Fibrosis scoring BWG:
Aim: To standardize fibrosis scoring in renal native and allograft biopsies, and conduct multi-center reproducibility trials to improve interobserver agreement.
To participate, please contact Robert Colvin, MD, COLVIN@HELIX.MGH.HARVARD.EDU
Polyoma virus nephropathy staging BWG:
Aim: To ensure the reproducibility of the new polyoma virus nephropathy staging, which was approved by consensus with pending training trials.
To participate, please contact Volker Nickeleit, MD, email@example.com
Glomerular lesion scoring BWG:
Aim: To re-examine scoring glomerular double contours (cg), glomerulitis (g), and mesangial matrix increase (mm) aiming at refinement of these criteria to increase the interobserver reproducibility.
To participate, please contact Mark Haas, MD, PhD, firstname.lastname@example.org
Molecular Pathology BWG:
Aim: To combine graft biopsy findings and molecular parameters for diagnosis in the near-future. The group led by Phil Halloran will facilitate the consensus about how and which molecular markers can be integrated into the Banff classification. RT-PCR or chip (with few genes) based molecular measurements may be incorporated into the existing histology-based Banff classification and/or discovery of new diagnostic and/or prognostic tissue markers could be feasible with the help of omics technologies.
To participate, please contact Philip Halloran, MD, FRCPC, OC, email@example.com
Aim: To plan Banff training courses, proficiency tests, and immunohistochemistry (C4d and BK) multicentre staining trials.
To participate, please contact Michael Mengel, MD, firstname.lastname@example.org
Figure 1. Established Working Groups at the Banff 2009 meeting aiming at addressing current unmet needs within the Banff classification to support or refute potential changes to the classification via conducting multi-center trials.
(Sis B, Mengel
M, Haas M, Colvin RB, Halloran PF, Racusen LC, Solez K et al. Banff ’09 Meeting
Report: Antibody Mediated Graft Deterioration and Implementation of Banff
Working Groups. Submitted, 2009)
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