Banff 2022 Vascularized Composite Allotransplantation Meeting Report: Diagnostic criteria for vascular changes

Linda C Cendales; Alton B Farris; Ivy Rosales; David Elder; Armando Gamboa-Dominguez; Bruce Gelb; Fadi Issa; Kadiyala Ravindra; Brian J Nankivell; Simon Talbot; Xiaowei G Xu; Dimitrios Moris; Cinthia B Drachenberg; Jean Kanitakis; Maria Angelica Selim

doi:10.1016/j.ajt.2023.12.023

Banff 2022 Vascularized Composite Allotransplantation Meeting Report: Diagnostic criteria for vascular changes

Am J Transplant. 2024 May;24(5):716-723. doi: 10.1016/j.ajt.2023.12.023. Epub 2024 Jan 28.

Authors

Affiliations

¹ Department of Surgery, Duke University, Durham, North Carolina, USA. Electronic address: Linda.Cendales@duke.edu.
² Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, USA.
³ Department of Pathology, Immunopathology Research Laboratory, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
⁴ Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁵ Departamento de Patología. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
⁶ Department of Surgery, New York University Grossman School of Medicine, New York, New York, USA.
⁷ Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
⁸ Department of Surgery, Duke University, Durham, North Carolina, USA.
⁹ Department of Renal Medicine, Westmead Hospital, Sydney, Australia.
¹⁰ Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
¹¹ Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
¹² Department of Dermatology, Ed. Herriot Hospital, Lyon, and Dept. of Pathology, Lyon Sud Hospital Center, Pierre Bénite, France.
¹³ Department of Pathology, Duke University, Durham, North Carolina, USA.

PMID: 38286355
DOI: 10.1016/j.ajt.2023.12.023

Abstract

As more data become available, the Banff 2007 working classification of skin-containing vascularized composite allograft (VCA) pathology is expected to evolve and develop. This report represents the Banff VCA Working Group's consensus on the first revision of the 2007 scoring system. Prior to the 2022 Banff-CanXadian Society of Transplantation Joint Meeting, 83 clinicians and/or researchers were invited to a virtual meeting to discuss whether the 2007 Banff VCA system called for a revision. Unanimously, it was determined that the vascular changes were to be included in the first revision. Subsequently, 2 international online surveys, each followed by virtual discussions, were launched. The goals were (1) to identify which changes define severe rejection, (2) to grade their importance in the evaluation of severe rejection, and (3) to identify emerging criteria to diagnose rejection. A final hybrid (in-person and virtual) discussion at the Banff/Canadian Society of Transplantation Joint Meeting finalized the terminology, the definition, a scoring system, and a reporting system of the vascular changes. This proposal represents an international consensus on this topic and establishes the first revision of the Banff 2007 working classification of skin-containing vascularized composite allograft pathology.

Keywords: Banff; histology; rejection; scoring system; skin; vascularized composite allograft.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Graft Rejection* / diagnosis
Graft Rejection* / etiology
Humans
Vascularized Composite Allotransplantation*