Table 1.
Summary of active Banff 2015 working groups
| Leaders | Issues to address | Group findings/plans | |
|---|---|---|---|
| TCMR | V. Nickeleit, P. Randhawa | Possible incorporation of i‐IFTA into classification; possible elimination of borderline category; reevaluate thresholds for inflammation and t and possible addition of other findings (e.g. edema) to TCMR diagnostic criteria | Group currently collecting cases of “pure” TCMR (no DSA or C4d) for pathologic evaluation and clinicopathologic correlation |
| Sensitized | L. Cornell, E. Kraus, S. Bagnasco, C. Schinstock, D. Dadhania | Define criteria for HS patients, determine consensus for what personnel and facilities are needed for centers to perform transplantation in HS recipients, standardize the definitions related to management of sensitized transplant recipients | Survey results presented by L. Cornell at 2015 Banff conference; expanded survey, future discussions to address core issues; prepare consensus paper for publication |
| Molecular | M. Mengel, B. Sis | Develop consensus guidelines for circumstances under which it is advisable to apply molecular analysis to renal biopsy tissue and/or serum/urine collected at the time of biopsy; determine the best molecular studies to perform with the aim of generating the needed evidence for adoption of molecular diagnostics into the Banff classification; standardize diagnostic criteria for molecular microscope | Single‐center data using the NanoString method on FFPE tissue presented by Banu Sis at the Banff 2015 conference; validation needed of biopsies from additional centers |
| Electron microscopy | C. Roufosse, H.K. Singh | Interobserver variability and clinical correlations in cg1a lesions and ptcml scoring; potential refinement of ptcml scoring criteria; criteria for amount of GBM reduplication and immune complex‐type deposits allowable in cg1a; multicenter study of the natural history, associations, and predictive value of cg1a and ptcml using consensus criteria | Survey of current practice completed June 2016; circulation of images for interobserver reproducibility, fall 2016; multicenter study 2017–2018 |
| TMAa | M. Afrouzian, J. Becker, H. Liapis, S. Seshan | Generate consensus regarding diagnostic criteria for TMA in renal allografts using histopathology/laboratory data/molecular genetics correlation |
Survey 1 circulated in January 2016; results have been shared with the working group participants. Plan: TMA experts defined and identified; will collect ≈30 cases; generate virtual slides and run digital evaluation |
| Recurrent glomerular diseasea | N. Alachkar | Focus on glomerulopathies: IgA nephropathy, FSGS, MPGN/C3 glomerulopathy; what are frequencies, clinical manifestations, and pathologic characteristics of recurrent/de novo disease? Can any of these predict recurrence and/or graft outcomes? | New working group |
| Composite surrogate end pointsa | A. Loupy, B. Orandi | Respond to the unmet need raised by the FDA meeting held in Arlington, Virginia, in 2015: Build a validated multicenter composite scoring system integrating histopathology with other relevant allograft biomarkers to predict long‐term allograft outcome | New working group |
cg, glomerular double contours; DSA, donor‐specific antibody; FDA, U.S. Food and Drug Administration; FFPE, formalin‐fixed, paraffin‐embedded; FSGS, focal segmental glomerulosclerosis; GBM, glomerular basement membrane; HS, highly sensitized; i‐IFTA, interstitial inflammation in areas of interstitial fibrosis and tubular atrophy; MPGN, membranoproliferative glomerulonephritis; ptcml, peritubular capillary basement membrane multilayering; t, tubulitis; TCMR, T cell–mediated rejection; TMA, thrombotic microangiopathy.
a
New working group.