Banff 2022 Kidney Commentary: Reflections and Future Directions.

Autor:	Rabant M; Department of Pathology, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France., Adam BA; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada., Aubert O; Kidney Transplant Department, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France., Böhmig GA; Department of Medicine III, Medical University of Vienna, Vienna, Austria., Clahsen Van-Groningen M; Department of Pathology and Clinical Bioinformatics, Erasmus MC Transplant Institute, Rotterdam, the Netherlands.; Institute of Experimental Medicine and Systems Biology, RWTH Aachen University, Aachen, Germany., Cornell LD; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN., de Vries APJ; Division of Nephrology, Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands.; Leiden Transplant Center, Leiden University Medical Center, Leiden, the Netherlands., Huang E; Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA., Kozakowski N; Department of Pathology, Medical University of Vienna, Vienna, Austria., Perkowska-Ptasinska A; Department of Pathology, Medical University of Warsaw, Warsaw, Poland., Riella LV; Nephrology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA., Rosales IA; Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA., Schinstock C; Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN., Simmonds N; Department of Pathology, Guys and St Thomas' NHS Foundation Trust, London, United Kingdom., Thaunat O; Department of Transplantation, Nephrology and Clinical Immunology, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France., Willicombe M; Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, United Kingdom.
Jazyk:	angličtina
Zdroj:	Transplantation [Transplantation] 2024 Jun 18. Date of Electronic Publication: 2024 Jun 18.
DOI:	10.1097/TP.0000000000005112
Abstrakt:	In September 2022, in Banff, Alberta, Canada, the XVIth Banff meeting, corresponding to the 30th anniversary of the Banff classification, was held, leading to 2 recent publications. Discussions at the Banff meeting focused on proposing improvements to the Banff process as a whole. In line with this, a unique opportunity was offered to a selected group of 16 representatives from the pathology and transplant nephrology community, experts in the field of kidney transplantation, to review these 2 Banff manuscripts. The aim was to provide an insightful commentary, to gauge any prospective influence the proposed changes may have, and to identify any potential areas for future enhancement within the Banff classification. The group expressed its satisfaction with the incorporation of 2 new entities, namely "microvascular inflammation/injury donor-specific antibodies-negative and C4d negative" and "probable antibody-mediated rejection," into category 2. These changes expand the classification, facilitating the capture of more biopsies and providing an opportunity to explore the clinical implications of these lesions further. However, we found that the Banff classification remains complex, potentially hindering its widespread utilization, even if a degree of complexity may be unavoidable given the intricate pathophysiology of kidney allograft pathology. Addressing the histomorphologic diagnosis of chronic active T cell-mediated rejection (CA TCMR), potentially reconsidering a diagnostic-agnostic approach, as for category 2, to inflammation in interstitial fibrosis and tubular atrophy and chronic active T cell-mediated rejection was also an important objective. Furthermore, we felt a need for more evidence before molecular diagnostics could be routinely integrated and emphasized the need for clinical and histologic context determination and the substantiation of its clinical impact through rigorous clinical trials. Finally, our discussions stressed the ongoing necessity for multidisciplinary decision-making regarding patient care. Competing Interests: The authors declare no funding or conflicts of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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