移植技術と研究

Revisiting IF/TA Category of Banff Working Classification of Renal Allograft Pathology: Have the Objectives been Achieved?

Abstract

Muhammed Mubarak and Javed I Kazi

Interstitial fibrosis/tubular atrophy (IF/TA) is, like its predecessor of Chronic Allograft Nephropathy (CAN), a purely descriptive designation depicting the morphological appearances of Chronic Sclerosing lesions observed on renal allograft biopsies in a variety of clinical settings. The term was introduced by the Banff classification in its 2005 meeting as a replacement for the then popular and often misunderstood category 5 of the Banff classification, i.e., the CAN. The aim was to encourage the transplant pathologists to look for and identify the specific causes of late allograft dysfunction on renal allograft biopsies and not just simply dump all the chronic transplant lesions into the paper wastebasket category of CAN. This editorial explores the rationale behind this change and whether the objectives stipulated have been achieved in real practice. We are of the view that the time has arrived to revisit this change of category and its impact on clinical practice in a systematic manner perhaps by one of the Banff working groups.