Banff 2011 Meeting Report

Every two years since 1991 Banff Meeting was held. It is a scientific gathering focusing on transplantation organ. The latest one was on 5-10 June 2011. Here are the topics related to kidney transplant being discussed.

• One of the difficulties relating to assessing and managing presensitized patients is that there is no solid, reliable way of characterizing donor specific antibody (DSA). DSAs are not created equal. Some may not be harmful to the allografts. Better ways to assess DSAs are being developed. On the treatment side, randomized controlled trial is needed to assess efficiency of multimodal treatments. Cases need to be stratified, including into antibody-mediated rejection (ABMR) occuring in presensitized patient vs de novo.
• C4d has limitation in ABMR diagnosis. More weight is placed on microcirculation inflammation/injury and DSA. The intimal arteritis (v lesion) seems to associate with both T cell mediated rejection (TCMR) and ABMR. 
• Working group was set up to define C4d negative ABMR. 
• Mild subclinical TCMR in early transplant period has molecular profile indicating injury-induced inflammation and is not associated with progression of graft fibrosis. However, this mild TCMR may relate to progressive fibrosis in late (1 year) transplant. 
• Urine and blood biomarker may help detect TCMR
• There is no change to the previous (2009) Banff classification.