Frequently Asked Question

What is the Banff classification for renal allograft rejection?
Answer
The Banff Schema is described in the report of the Third Banff Conference ). T-cell mediated rejection is discussed as well as late-appearing antibody-mediated rejection, recently more fully described by Trpkov et al. in the June 15th issue of Transplantation 61(11):1582-1592, 1996 .

Quantitative criteria for the three lesions used to diagnose rejection in the Banff Classification are as follows (tables modified from Kidney International 44:411-422, 1993).
Mild (Grade 1) acute rejection requires t2 and i2 or i3;

Moderate (2A) rejection requires t3 and i2 or i3, moderate (Grade 2B) rejection requires v1 or v2;

Severe (Grade 3) rejection requires v3:
Table 1. Quantitative criteria for tubulitis
("t" score 0-3+)


0 = No mononuclear inflammatory cell in tubules

1 = Foci with 1 to 4 mononuclear cells per tubular cross section or ten tubular cells

2 = Foci with 5 to 10 mononuclear cells per tubular cross section

3 = Foci with >10 mononuclear cells per tubular cross section

Table 2. Quantitative criteria for interstitial mononuclear cell inflammation
("i" score 0-3+)


0 = No or trivial interstitial inflammation

1 = up to 25% or parenchyma inflamed

2 = 26-50% of parenchyma inflamed

3 = >50% of parenchyma inflamed

Table 3. Quantitiative criteria for intimal arteritis
("v" score 0-3+)


0 = No arteritis

1 = Mild-to-moderate intimal arteritis in at least one arterial cross section.

2 = Moderate-to severe intimal arteritis in more than one arterial cross section

3 = Severe intimal arteritis in many arterial cross sections and/or "transmural" arteritis, fibrinoid change and medial smooth muscle necrosis, often with patchy infarction and interstitial hemorrhage.

September, 1996
(Kim G. Solez, M.D. University of Alberta, Canada)

How do I calculate Kt/v in pregnant patient who is getting dialysis 4 times per week by using the HD calculator bcause there is no option for 4 times a week to select?
napisvadee wongchavanich
irving, tx - Wednesday, December 16, 1998 at 18:06:04 (PST)

Do you believe that transplantation have better outcomes than CAPD,( with relationship mortality and morbility)in older patiens(more than 65 years old). Thanks for your answer.
jairo hernan gonzalez (jagbauti@telesat.com.co)
Cali, Valle - Wednesday, July 07, 1999 at 16:10:06 (PDT)

yes,through our experience of hundreds of patients,part of them over 60 years old. they all take capd for many years, after transplantation,they all feel better quality of life.
yifei zhang (hefeizhyf@china.con)
hefei, anhui - Saturday, July 22, 2000 at 15:18:24 (PDT)