2016 Volume 4 Issue 1 Pages 40-49
Since the introduction of the word “antibody mediated rejection” in Banff 1997 classification, the main scheme of the renal transplant pathology has shown big shift toward antibody mediated rejection more than 15 years. In the era of established classification of antibody-mediated rejection, Banff meeting in 2015 was highlighted with tubulointerstitial cellular immunoreaction that can be trigered by T-cell mediated reaction as well as borderline changes. The mew study group target the T-cell induced graft injury by using traditional approaches in the era of routine C4d staining and DSA testing. Another Banff working group clarified the clinical and pathological significance of isolated v-lesion which is charactirzed by endoarteritis with mild tubulitis and interstitial inflammation. They concluded that isolated v-lesion should be regarded as rejection and need to be treated according to the DSA status. Regarding the BK virus nephropathy, a big leap was the revised classification which reflects the potential risk of graft loss by combining the polyoma virus load levels in renal tubular epithelial cells and Banff interstitial fibrosis score. In addition to the advancement in Banff 2015 meeting, this review also discusses the practical approach of renal transplant pathology in the era of much talk about DSA and “molecular” Banff classification.
