Banff Working Groups (BWGs)

Six BWGs aiming at addressing unmet needs in transplantation pathology were established at the 10^th Banff Conference on Allograft Pathology (Figure 1). 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 management.

Transplant physicians from around the world are encouraged to participate in the BWGs.

1.  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, bsis@ualberta.ca

    

2. 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

    

3.  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, volker_nickeleit@med.unc.edu

    

4. 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, mark.haas@cshs.org
    

5. 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, phil.halloran@ualberta.ca
    

6. Quality assurance:
   
   Aim: To plan Banff training courses, proficiency tests, and immunohistochemistry (C4d and BK) multicentre staining trials.
   
   To participate, please contact Michael Mengel, MD, mengel@med.ualberta.ca

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)