Banff 2022 liver group meeting report: monitoring long term allograft health.

The Banff Working Group on Liver Allograft Pathology met in September 2022. Participants included hepatologists, surgeons, pathologists, immunologists and histocompatibility specialists. Presentations and discussions focused on the evaluation of long-term allograft health, including non-invasive and tissue monitoring, immunosuppression optimisation and long-term structural changes. Potential revision of the rejection classification scheme to better accommodate and communicate late T cell-mediated rejection patterns and related structural changes, such as nodular regenerative hyperplasia, were discussed. Improved stratification of long-term maintenance immunosuppression to match the heterogeneity of patient settings will be central to improving long-term patient survival. Such personalised therapeutics are in turn contingent on better understanding and monitoring of allograft status within a rational decision-making approach, likely to be facilitated in implementation with emerging decision support tools. Proposed revisions to rejection classification emerging from the meeting include incorporation of interface hepatitis and fibrosis staging. These will be opened to online testing, modified accordingly and subject to consensus discussion leading up to the next Banff conference.

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Disclosure With 3 exceptions detailed below, the authors of this manuscript have confirmed they have no conflict of interest to disclose as described by the American Journal of Transplantation. The 3 authors, and the interest(s) declared are:1. Annette Jackson: HLA consultant (Hansa Biopharma); Research reagents/grant (CareDx); Speaker bureau (One Lambda/ThermoFisher).2. Josh Levitsky: Advisor (Eurofins; eGenesis); Speaker for Takeda; Mallinckrodt.3. Richard Taubert: Research grant (Oncocyte/Chronix Biomedical)