Banff 2022 Liver Group Meeting report: Monitoring long-term allograft health

Christopher O.C. Bellamy, Jacqueline G. O'Leary, Oyedele Adeyi, Nahed Baddour, Ibrahim Batal, John Bucuvalas, Arnaud Del Bello, Mohamed El Hag, Magda El-Monayeri, Alton B. Farris, Sandy Feng, Maria Isabel Fiel, Sandra E. Fischer, John Fung, Krzysztof Grzyb, Maha Guimei, Hironori Haga, John Hart, Annette M. Jackson, Elmar JaeckelNigar A. Khurram, Stuart J. Knechtle, Drew Lesniak, Josh Levitsky, Geoff McCaughan, Catriona McKenzie, Claudia Mescoli, Rosa Miquel, Marta I. Minervini, Imad Ahmad Nasser, Desley Neil, Maura F. O'Neil, Orit Pappo, Parmjeet Randhawa, Phillip Ruiz, Alberto Sanchez Fueyo, Deborah Schady, Thomas Schiano, Mylene Sebagh, Maxwell Smith, Heather L. Stevenson, Timucin Taner, Richard Taubert, Swan Thung, Pavel Trunecka, Hanlin L. Wang, Michelle Wood-Trageser, Funda Yilmaz, Yoh Zen, Adriana Zeevi, Anthony J. Demetris

Research output: Contribution to journalArticlepeer-review

Abstract

The Banff Working Group on Liver Allograft Pathology met in September 2022. Participants included hepatologists, surgeons, pathologists, immunologists, and histocompatibility specialists. Presentations and discussions focused on the evaluation of long-term allograft health, including noninvasive and tissue monitoring, immunosuppression optimization, and long-term structural changes. Potential revision of the rejection classification scheme to better accommodate and communicate late T cell-mediated rejection patterns and related structural changes, such as nodular regenerative hyperplasia, were discussed. Improved stratification of long-term maintenance immunosuppression to match the heterogeneity of patient settings will be central to improving long-term patient survival. Such personalized therapeutics are in turn contingent on a better understanding and monitoring of allograft status within a rational decision-making approach, likely to be facilitated in implementation with emerging decision-support tools. Proposed revisions to rejection classification emerging from the meeting include the incorporation of interface hepatitis and fibrosis staging. These will be opened to online testing, modified accordingly, and subject to consensus discussion leading up to the next Banff conference.

Original languageEnglish (US)
JournalAmerican Journal of Transplantation
DOIs
StateAccepted/In press - 2024

Keywords

  • Banff classification
  • T cell-mediated rejection
  • alloimmunity
  • anatomy
  • antibody-mediated rejection
  • immunosuppression
  • liver transplantation
  • pathology
  • protocol biopsy

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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