Banff 2003 meeting report: New diagnostic insights and standards

The Seventh Banff Conference on Allograft Pathology was held June 14-18, 2003 in Aberdeen, Scotland representing the latest iteration of the international consensus meeting, which develops world-wide standards for interpretation of allograft biopsies. The meeting is an important force behind standardized slide interpretation to strengthen endpoints in international clinical trials. Of participants polled 87% reported that they would alter clinical practice as a direct consequence of the meeting and its content. Advances were made in many areas including tubulitis mechanisms, real-time polymerase chain reaction (PCR) gene analysis and microarrays in rejection diagnosis, tolerance/accommodation/immunomodulation, he role of monocytes and macrophages in rejection and C4d as a marker for antibody-mediated rejection. A provisional scoring system for peritubular capillary inflammatory cell accumulation in antibody-mediated rejection was presented for testing, as well as plans for a nephrectomy study to determine specificity of vascular lesions of rejection. Future meetings are planned for 2005 (Edmonton), 2007 and 2009, with active ongoing Internet discussion between meetings.