The Banff 2024 Kidney Meeting Report: rejection as a spectrum of phenotypes and focus on differential diagnostic reasoning
Naesens, Maarten Roufosse, Candice Cornell, Lynn D Haas, Mark Mannon, Roslyn B Afrouzian, Marjan Akalin, Enver Alachkar, Nada Alexander, Mariam P Bagnasco, Serena M
Naesens, Maarten
Roufosse, Candice
Cornell, Lynn D
Haas, Mark
Mannon, Roslyn B
Afrouzian, Marjan
Akalin, Enver
Alachkar, Nada
Alexander, Mariam P
Bagnasco, Serena M
Abstract
The XVIIth Banff meeting for transplant pathology was held in Paris, France, from September 16, 2024 to September 20, 2024, hosted by the Paris Institute for Transplantation & Organ Regeneration. The Banff 2024 meeting resulted in no changes to the Banff kidney classification. Important outputs of the meeting were a reaffirmation of the clinical usefulness of the clinical reasoning framework and flowchart for cases with microvascular inflammation/antibody-mediated rejection introduced at the Banff 2022 meeting and the introduction of a similar flowchart for tubulointerstitial inflammation and intimal arteritis (v lesion). The meeting highlighted the complexity of the immunologic processes (alloimmune and others) that lead to allograft inflammation and the need to strengthen the Banff system for differential diagnostic reasoning. Guidance is put in place for cases with incomplete/mixed phenotypes, which acknowledges the limits of our understanding. A proposal for potential future implementation of activity and chronicity indices was discussed, as well as digital and biopsy-based molecular tools that have the potential to help transform the classification into a probabilistic tool reflective of the underlying immunologic processes. Finally, guidelines for reporting of glomerular disease in the posttransplant setting were developed.
MIDER Authors
Date
2026-03-05
Type
Article
Subject
Biopsy, Graft rejection, Diagnosis, differential, Kidney transplantation, Machine learning
Collections
Citation
Naesens M, Roufosse C, Cornell LD, Haas M, Mannon RB, Afrouzian M, Akalin E, Alachkar N, Alexander MP, Bagnasco SM, Batal I, Böhmig GA, Boor P, Broecker V, Chang A, Clahsen-Van Groningen M, Coley SM, Colvin RB, Dadhania D, Drachenberg CB, Elias M, Farris AB, Fogo AB, Fowler K, Gibson IW, Goutaudier V, Huang E, Husain SA, Jackson AM, Kers J, Kikić Ž, Kozakowski N, Kung V, Liapis H, Louis K, Muthukumar T, Nankivell B, Neil DAH, Rabant M, Randhawa P, Riella LV, Rosales I, Royal V, Sapir-Pichhadze R, Schachtner T, Schinstock C, Seshan SV, Sharif A, Solez K, Thaunat O, Van Midden D, Ventura-Aguiar P, Willicombe M, Lefaucheur C, Loupy A, Mengel M. The Banff 2024 Kidney Meeting Report: Rejection as a spectrum of phenotypes and focus on differential diagnostic reasoning. Am J Transplant. 2026 Mar 5:S1600-6135(26)00040-7. doi: 10.1016/j.ajt.2026.01.018. Epub ahead of print.
Journal / Source Title
American Journal of Transplantation
DOI
10.1016/j.ajt.2026.01.018
PMID
41888020
Publisher
Elsevier
Publisher’s URL
https://www.sciencedirect.com/journal/american-journal-of-transplantation/
https://onlinelibrary.wiley.com/journal/16006143
https://onlinelibrary.wiley.com/journal/16006143