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
Affiliations
KU Leuven; Imperial College London; Mayo Clinic; University of Calgary; Cedars-Sinai Medical Center; University of Nebraska Medical Center; University of Texas Medical Branch at Galveston; Albert Einstein College of Medicine; The Johns Hopkins University School of Medicine; Columbia University Irving Medical Center; Medical University of Vienna; University Hospital Aachen; RWTH Aachen University; Sahlgrenska University Hospital; University of Chicago; Erasmus University Center Rotterdam; Arkana Laboratories; Massachusetts General Hospital; Harvard Medical School; Cornell University; University of Maryland; Assistance Publique-Hôpitaux de Paris; Emory University; Vanderbilt University Medical Center; The Voice of the Patient Saint Louis; University of Manitoba; Université Paris Cité; Columbia University Medical Center; Duke University; Leiden University; Amsterdam University Medical Center; University of Amsterdam; Oregon Health and Science University; Ludwig Maximilian University Munich; Westmead Hospital; University Hospitals Birmingham NHS Foundation Trust; University of Birmingham; University of Pittsburgh; University of Montreal; McGill University; University Hospital Zurich; University of Alberta; Hospices Civils de Lyon; Radboud University Medical Center; Hospital Clínic de Barcelona
Date
2026-03-05
Type
Article
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.