The Banff 2019 Kidney Meeting Report (I): Updates on and clarification of criteria for T cell– and antibody-mediated rejection

Alexandre Loupy, Mark Haas, Candice Roufosse, Maarten Naesens, Benjamin Adam, Marjan Afrouzian, Enver Akalin, Nada Alachkar, Serena Bagnasco, Jan U. Becker, Lynn D. Cornell, Marian C. Clahsen-van Groningen, Anthony J. Demetris, Duska Dragun, Jean Paul Duong van Huyen, Alton B. Farris, Agnes B. Fogo, Ian W. Gibson, Denis Glotz, Juliette GueguenZeljko Kikic, Nicolas Kozakowski, Edward Kraus, Carmen Lefaucheur, Helen Liapis, Roslyn B. Mannon, Robert A. Montgomery, Brian J. Nankivell, Volker Nickeleit, Peter Nickerson, Marion Rabant, Lorraine Racusen, Parmjeet Randhawa, Blaise Robin, Ivy A. Rosales, Ruth Sapir-Pichhadze, Carrie A. Schinstock, Daniel Seron, Harsharan K. Singh, Rex N. Smith, Mark D. Stegall, Adriana Zeevi, Kim Solez, Robert B. Colvin, Michael Mengel

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


The XV. Banff conference for allograft pathology was held in conjunction with the annual meeting of the American Society for Histocompatibility and Immunogenetics in Pittsburgh, PA (USA) and focused on refining recent updates to the classification, advances from the Banff working groups, and standardization of molecular diagnostics. This report on kidney transplant pathology details clarifications and refinements to the criteria for chronic active (CA) T cell–mediated rejection (TCMR), borderline, and antibody-mediated rejection (ABMR). The main focus of kidney sessions was on how to address biopsies meeting criteria for CA TCMR plus borderline or acute TCMR. Recent studies on the clinical impact of borderline infiltrates were also presented to clarify whether the threshold for interstitial inflammation in diagnosis of borderline should be i0 or i1. Sessions on ABMR focused on biopsies showing microvascular inflammation in the absence of C4d staining or detectable donor-specific antibodies; the potential value of molecular diagnostics in such cases and recommendations for use of the latter in the setting of solid organ transplantation are presented in the accompanying meeting report. Finally, several speakers discussed the capabilities of artificial intelligence and the potential for use of machine learning algorithms in diagnosis and personalized therapeutics in solid organ transplantation.

Original languageEnglish (US)
Pages (from-to)2318-2331
Number of pages14
JournalAmerican Journal of Transplantation
Issue number9
StatePublished - Sep 1 2020


  • classification systems: Banff classification
  • clinical decision-making
  • clinical research/practice
  • kidney (allograft) function/dysfunction
  • kidney transplantation/nephrology
  • molecular biology: mRNA/mRNA expression
  • pathology/histopathology
  • rejection
  • translational research/science

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)


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