Banff



Sixth Banff Conference on
Allograft Pathology

April 21 - 28, 2001
Rimrock Resort Hotel
Banff, Alberta, Canada



 

Kim Solez, M.D. and Lorraine C. Racusen, M.D., Course Directors
A. J. Demetris, M.D., Coordinator for Liver Pathology Sessions
Phil Halloran, M.D., Coordinator for Antibody Mediated Rejection Sessions
Parmjeet Randhawa, M.D., Coordinator for Viral Disease Sessions
E. Rene Rodriguez, M.D., Coordinator for Cardiac Sessions

Sponsored by educational grants from: Bristol-Myers Squibb, Fujisawa, Genentech, Inc., Novartis Pharma AG, Roche Laboratories, and Wyeth-Ayerst Research

Programme:

Saturday, 21 April 2001
Arrive in Banff. Check into room at Rimrock Resort Hotel.

7:00 p.m. Private Reception (Salons A&B)
09:00 -  Set-up posters (Wildrose Prefunction Space)
10:00 p.m.

Sunday, 22 April 2001

7:30-8:30 Continental Breakfast (Salons A&B)
Set-up posters (Wildrose Prefunction Space)
Salon C
8:30-8:50  Welcome, Opening Remarks - Lorraine Racusen, M.D. and Kim Solez, M.D.
Plenary session
8:50 - 9:30 Keynote Address: Winds of Change: The New Medicine and Transplantation.  Sheila Moriber-Katz, M.D., M.B.A.
9:30-10:00 Refreshment Break
Salon C
AM-PM
*Kidney
*Parallel session: Updates of Schemas for Diagnosis of Rejection in Abdominal Transplants - A. Jake Demetris, M.D. and Kim Solez, M.D., Chairs.
10:00 - 10:20 The Banff 97 working classification for renal allograft pathology: the current challenge. - Lorraine Racusen, M.D.
10:20 - 10:40 Training and convergence in the readings for allograft biopsies using the Banff schema - Results of a Multi-center European study. - Peter Furness, MA, BM, BCh, PhD, FRCPath
10:40 - 11:00 Acute liver allograft rejection: Assessment of the Banff schema for grading. - A. Jake Demetris, M.D.
11:00 - 11:30 Grading system for acute rejection in pancreas allografts - Are Changes Needed? - Cinthia Drachenburg, M.D.
11:30 - 1:00 Lunch (Salons A&B)
Sum Scoring - Renal allografts - Byron Croker, M.D. and Lillian Gaber, M.D., Chairs.
1:00 - 1:20 The use of Banff sum scoring for prognostic studies. - Lillian Gaber, M.D.
1:20 - 1:40 Modification of the Banff sum scores for monocyte/macrophages. - Byron Croker, M.D. and Titte Srinivas, M.D
1:40 - 2:00 Reproducibility of scoring of individual morphologic features for Banff scoring. - Niels Marcussen, M.D.
2:00 - 2:20 A Proposal for modification of sum scoring in the Banff schema. - Byron Croker, M.D. and Lillian Gaber, M.D. 
2:20 – 2:50 Refreshment Break (Wildrose Prefunction Space)
2:50 - 4:00 Consensus discussion: Focus will be on developing a consensus regarding the use of sum scoring in allograft biopsies.
Hawthorne Room
*Heart/Lung *Parallel session: Updates of Schemas for Diagnosis of Rejection in Thoracic Transplants - E. Rene Rodriguez, M.D. and Gayle Winters, M.D., Chairs
8:50 - 9:10 Historical perspective of the ISHLT Working Formulation. - Gayle Winters, M.D.
9:10 - 9:30 Current Working Formulation: Definitions and Pitfalls. - E. Rene Rodriguez, M.D.
9:30 - 9:50 Myocyte Damage. - Norman Ratliff, M.D.
9:50 - 10:10 Humoral Rejection in the Heart. - Michael Fishbein, M.D.
10:10 - 10:30 Refreshment Break (Wildrose Prefunction Space)
10:30 - 10:50 Modifications of the pathology of acute rejection by therapy. - Eloisa Arbustini, M.D.
10:50 - 11:10 How is the diagnosis of rejection in cardiac allografts rendered? - Marisa Crespo, M.D. and James Kirklin, M.D.
11:10 - 11:30 Molecular Markers of Rejection in the Heart. - E. Rene Rodriguez, M.D.
11:30 - 11:50 Predictors of Vasculopathy.
  Role of Viruses
    Cytomegalovirus
    Adenovirus
    Parvovirus

  Role of Bacteria
    Chlamydia sp.

12:00 - 1:00 Lunch (Salons A&B)
1:00 - 4:00 Consensus discussion: Focus will be on the grading schema for heart allograft rejection - to revise or not to revise.
2:20 – 2:50 Refreshment Break (Wildrose Prefunction Space)

 

Monday, 23 April 2001

7:00-8:00 Continental Breakfast (Salons A&B)
Salon C
AM Plenary Session: Antibody-mediated rejection - Phil Halloran, M.D., Chair
8:00 - 8:15 The evolution of antibody-mediated rejection. - Phil Halloran, M.D.
8:15 - 8:30 Data on antibody-mediated rejection:  clinical, immunological, pathological and C4d staining and a proposal for a definition of the syndrome. - Robert Colvin, M.D.
8:30 - 8:45 C4d staining in the Edmonton rejection database. - Patricia Campbell, M.D.
8:45 - 9:00 Clinical significance of C4d staining in a setting of aggressive therapy. - Volker Nickeleit, M.D.
9:00-9:15 Experience with anti-CD20 and other treatments for antibody-mediated rejection syndromes. - Robert Montgomery, M.D.
9:15-9:30 Experience with suppression of anti-HLA antibody. - Denis Glotz, M.D.
9:30-9:45 Population data on anti-HLA antibody, delayed graft function, acute rejection, and outcomes. - Michael Cecka, M.D.
9:45- 10:00 C4d deposition in ABO incompatible renal transplants. - Kunio Morozumi, M.D.
10:00-10:30 Refreshment Break (Wildrose Prefunction Space)
10:30-10:45 Antibody-mediated heart syndromes. - Michael Fishbein, M.D.
10:45-11:00 Role of antibody in liver transplantation. - A. Jake Demetris, M.D.
11:00-12:00 Panel discussion: A proposal for defining antibody-mediated rejection syndromes.
12:00 - 1:00 Lunch (Salons A&B)
Salon C
*Kidney Parallel session:
Proposal for Clarification of the Nomenclature and Conceptual Basis of Chronic Allograft Dysfunction and Chronic Rejection
- Robert Colvin, M.D. and Phil Halloran, M.D., Chairs
1:00 - 1:10 Introducing the problem: mission impossible - paradoxes that must be solved and relationship to the "end points" process. - Phil Halloran, M.D.
1:10 - 1:25 Types of chronic lesions in kidney transplants. - Michael Mihatsch, M.D.
1:30 - 1:45 C4d staining in chronic rejection, chronic allograft fibrosis, chronic allograft dysfunction. - Robert Colvin, M.D.
1:50 - 2:05  Chronic Allograft Changes - 5 year follow-up in the MMF study. - Pekka Häyry, M.D. and Serdar Yilmaz, M.D.
2:10 - 2:25 What do we know about glomerulopathy in renal transplants? - Leen Paul, M.D.
2:30 - 2:45 Refreshment Break (Wildrose Prefunction Space)
2:50 - 3:05 Chronic changes in the biopsies from the tacrolimus studies. - Kim Solez, M.D.
3:10 - 3:25 Chronic allograft dysfunction and chronic rejection as a population phenomenon in the UNOS database: suggestions for clarification of the entities and nomenclature for database purposes. - Michael Cecka, M.D.
3:30 - 3:45 GFRs in the UNOS database: determinants of slopes and intercepts. - Larry Hunsicker, M.D.
3:50 - 5:00 Consensus Discussion on Pathology:  Kim Solez, M.D., Chair
Can we distinguish a defined entity called chronic rejection from the common lesions of CAN?
Focus will be on specific biopsy features that enable a more specific diagnosis of etiology of chronic changes and possible changes in the Banff nomenclature for chronic allograft changes
Includes: Leen Paul, Larry Hunsicker, Volker Nickeleit, Michael Mihatsch, Robert Colvin, Mike Cecka and others.
Key attendees: Robert Gordon, FDA representative, representatives from AST and ASTS who will be involved in the end points process.
Hawthorne Room
*Liver Parallel session:
Causes of Late Liver Allograft Dysfunction, with Emphasis on Recurrent or New Onset Disease
- A. Jake Demetris, M.D.  and Stefan Hubscher, M.D., Chiars
1:00 - 1:20 Recurrence of primary biliary cirrhosis after liver transplantation. - Urmila Khettry, M.D.
1:20 - 1:40 The spectrum of recurrent HCV after liver transplantation. - Stefan Hubscher, M.D.
1:40 - 2:00 De novo "autoimmune" hepatitis in long-term paediatric allograft recipients. - John Hart, M.D.
2:00 - 2:20 New onset "autoimmune" hepatitis in pediatric liver allograft recipients. - Aurelio Sonzogni, M.D.
2:20 - 2:40 Liver transplantation for alcoholic cirrhosis:  long-term follow-up and impact of disease recurrence. - Chris Bellamy, M.D.
2:40 - 3:00 Systematic 10 year biopsies of 156 liver transplant recipients. - Michel Reynès, M.D.
3:00 - 3:20 Refreshment Break (Wildrose Prefunction Space)
3:20 - 3:40 Host factors that contribute to hepatitis C progression. - Andrew Clouston, M.D.
3:40 - 4:00 Experience with living-related liver transplantation pathology. - Hirohiko Yamabe, M.D.
Pathophysiologic mechanisms of liver allograft injury and chronic rejection.
4:00 - 4:20 Causes of centrilobular necrosis. - Andrew Clouston, M.D.
4:20 - 4:40 Central venulitis in pediatric allograft recipients. - Emma Furth, M.D. and Alyssa Krasinskas, M.D.
4:40 - 5:00 Long-term follow-up by protocol biopsies of patients randomized to either neoral or tacrolimus. - Desley Neil, M.D.
5:00 - 5:20 Replicative senescence of biliary epithelial cells precedes bile duct loss in early chronic liver allograft rejection: Increased expression of p21 WAF1/Cip1 as a disease marker and the influence of immunosuppressive drugs. - A. Jake Demetris, M.D. and John Lunz III, M.D.
5:20 - 5:40 Long-term effects of low, medium, and high dose immunosuppression early after transplantation: an animal model of chronic liver allograft rejection with ongoing bile duct damage and central venulitis. - A. Jake Demetris, M.D.
5:40 - 6:00 A test of the 1999 Banff schema for chronic liver rejection. - Mylène Sebagh, M.D.
Yarrow Room
*Heart
1:00 - 5:00
Parallel session:
Continued consensus discussions of the schema for heart allografts - Where do we go from here?
- E. Rene Rodriguez, M.D. and Gayle Winters, M.D., Chiars
Discussion with Microscope session
Salon C
6:30 Buffet Dinner (Salons A&B)
7:00 - 9:00 New clinical end points incorporating pathology lesions: working dinner and evening meeting:   - Phil Halloran, M.D. and Kim Solez, M.D., Chairs
Incorporating the new pathology consensus into trials and databases:  GFR, CAN lesions, chronic rejection, and others as possible endpoints. The role of protocol biopsies in clinical trials. Results to be presented to the general group at a later point in the meeting.
Key attendees: Robert Gordon, FDA representative, representatives from AST and ASTS will be involved in the end points process.

 

Tuesday, 24 April 2001

7:00-7:30 Continental Breakfast (Salons A&B)
Salon C
7:30 - 8:20 Continued Consensus Discussion: Modification of the Banff - Chronic Grading Schema for Kidney. - Kim Solez, M.D.
8:20 Plenary Session: Morphologic criteria for donor selection - kidney - Parmjeet Randhawa, M.D., Chair
8:20 - 8:40 Are we discarding kidneys appropriately? - An analysis of cadaver donor and kidney biopsy parameters with correlation to transplant outcomes. - Martin F. Mozes, M.D.
8:40 - 9:00 Unused donor kidneys: The magnitude of the problem in New England. - Frank Delmonico, M.D.
9:00 - 9:20 Should I accept this kidney? A clinician's viewpoint. - Gabriel Danovitch, M.D.
9:20 - 9:40 Pathologic assessment of donor biopsies, kidney. - Parmjeet Randhawa, M.D.
9:40- 10:00 Prognostic features in donor biopsies, kidney. - Lorraine Racusen, M.D.
10:00-10:15 Refreshment Break ( Wildrose Prefunction Space)
10:15- 10:30 Glomerulosclerosis in African Americans - relevance to donor biopsies. - Agnes Fogo, M.D.
10:30-10:45 Non-heart beating donors. - Peter Furness, MA, BM, BCh, PhD, FRCPath
10:45- 11:00 A proposal for grading of changes in donor kidney biopsies. - Parmjeet Randhawa, M.D.
11:00-12:00 Consensus Discussion(s): Morphologic Assessment of Donor organs - A new grading system? - Kim Solez, M.D., Chair
12:00 - 1:00 Lunch (Salons A&B)
PM Salon C
1:00 - 1:30 Plenary Session: Other Methods of donor organ assessment/Broadening donor criteria. - Phil Halloran, M.D., Chair
1:30 - 2:00 Pump perfusion to assess organ vascular resistance. - Robert Montgomery, M.D.
2:00 - 2:30 Dual organ transplantation. - Robert Montgomery, M.D.
2:30 - 3:00 Cell aging/senescence assessment in organ allografts. - Phil Halloran, M.D.
3:00 - 3:30 Refreshment Break (Wildrose Prefunction Space)
3:30 - 4:00  Immunological assessment before transplantation - state of the art. - Ronald Kerman, M.D.
4:00 - 4:30 Pre-emptive strategies for transplantation across immunological barriers. - Robert Montgomery, M.D.
4:30 - 5:30 Consensus Discussion: Donor organ selection criteria - what is ideal? - Larry Hunsicker, M.D.

 

Wednesday, 25 April 2001

7:00-8:00 Continental Breakfast (Salons A&B)
Salon C
8:00 - 8:40 Special lecture - Reflections on Protocol Biopsies and Subclinical Rejection in 2001. - David Rush, M.D.
8:40 - 9:30 Major Address - Importance of Formal Classification of Rejection for Collaborative Studies in Transplantation. - Larry Hunsicker, M.D. and Steve Rose, Ph.D. (participating remotely)
9:30 Transplantation Telepathology - Are we there yet? - A. Jake Demetris, M.D. and Kim Solez, M.D., Chairs
9:30 - 9:50 Technological advances and Telepathology. - William F. Marovitz, PhD.
9:50 - 10:10 Experience with Transplantation Telepathology. - Marta Minervini, M.D.
10:10-10:40 Refreshment Break (Wildrose Prefunction Space)
10:40-11:20 Telepathology:  Status in Europe. - Peter Furness, MA, BM, BCh, PhD, FRCPath
11:20-11:40 Can Multi-spectrum high-resolution cameras change pathology? - Yukako Yagi
11:40-12:00 Portable telepathology. - Yukako Yagi
12:00 - 1:00 Lunch (Salons A&B)
Salon C
PM
Kidney
1:00 - 1:30
Viral infections in allografts - diagnosis and pathogenic factors Polyoma virus infection in the Kidney - Parmjeet Randhawa, M.D., Chair
1:30 - 2:00 The molecular epidemiology of BK and JC polyoma virus infections in man. - Gerald Stoner, M.D.
2:00 - 2:30 BK virus nephropathy: The Basel algorithm for diagnosis and patient management. - Volker Nickeleit, M.D.
2:30 - 3:00 Histologic/cytologic correlations in polyoma virus infection after renal transplantation. - Cinthia Drachenberg, M.D.
3:00 - 3:30 Refreshment Break (Wildrose Prefunction Space)
3:30 - 4:00 Polyoma virus infection after renal transplantation - The Pittsburgh experience. - Ron Shapiro, M.D.
4:00 - 4:30 Polyoma virus JC infection in the renal allograft. - Parmjeet Randhawa, M.D.
4:30 - 5:00 Cytomegalovirus and rejection. - Jeremy Chapman, M.D.
Slide set available for ad hoc viewing

 

Thursday, 26 April 2001

8:00-9:00 Continental Breakfast (Salons A&B)
AM Salon C
9:00 - 9:40 Plenary Session: Molecular Markers for Diagnosis and Prognosis-  Phil Halloran, M.D., Chair 
Keynote Address: Molecular Markers for Acute and Chronic Rejection - The Candidates. - Wayne Hancock, M.D.
9:40 - 10:00 Role of Granzyme, Interferon Gamma, and Cytotoxic Lymphocytes inn Acute Rejection in Renal Allografts:  Data from Knockout Mice and lessons for Renal Pathology. - Phil Halloran, M.D.
10:00-10:20 Refreshment Break (Wildrose Prefunction Space)
10:20-10:50 Special Address: Genomics in Transplantation. - Daniel Salomon, M.D.
10:50-11:05 Non Invasive Rejection Diagnosis Using Urine NMR Spectra. - David Rush, M.D.
11:05-11:20 C4D Staining and Prognosis in Renal Allografts. - Alex Magil, M.D.
11:20-11:35 Apoptosis in Renal transplants:  Implications for Long-Term Outcome. - John Papadimitriou, M.D.
11:35-12:00 Consensus Discussion - Molecular Markers to Diagnose Rejection - Are We Ready? - Kim Solez, M.D.
12:00 - 1:00 Lunch (Salons A&B)
OPEN AFTERNOON
(Acute Renal Failure Biopsy Conference - Dr. William F. Finn)
7:30 Closing Banquet (Salons A&B)

 

Friday, 27 April 2001

7:00-8:00 Continental Breakfast (Salons A&B)
Salon C
AM Final Plenary Session - presented by chairs of previous sessions
8:00 - 8:30 Summary reports: Updates
    Abdominal Transplants
    Heart Transplants
8:30 - 9:00 Summary report - Sum Scoring
9:00 - 9:30 Summary report - Antibody-mediated rejection
9:30 - 10:00 Summary report - Donor selection criteria
10:00-10:30 Refreshment Break (Wildrose Prefunction Space)
10:30 -11:00 Summary report - Chronic allograft changes
11:00 -11:30 Summary report - Viral infections and allografts
11:30-12:00  Summary report - Molecular Markers
12|:00-12:30 Summary report - Telepathology
12:30 - 1:30 Lunch (Salons A&B)
Salon C
PM Final open discussion / Plans for drafting of publications

 

Saturday, 28 April 2001
Departure

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