The Banff Classification of Kidney Transplant Pathology began in 1991 and has become the worldwide standard for interpreting transplant biopsies. It originated from consensus meetings held every two years in Banff, Alberta to establish histologic criteria for diagnosing rejection and other transplant conditions. The classification has expanded over time and been integrated with other specialty societies. It has had a significant scientific impact as evidenced by high citation rates. The Banff Foundation was established in 2013 to continue developing the classification through working groups and consensus-building. The course aims to keep the Banff process and classification relevant as new technologies like stem cell organ engineering emerge.

1. Kim Solez, MD

2. Over 20 Years Here I Have Never
Had A Problem IT Could Not Solve

3. Who Am I?

5. Banff Classification of Kidney Transplant Pathology
Histologic criteria for the diagnosis of rejection and
other conditions in the transplanted kidney, began
1991, updated and expanded every two years in
consensus meeting.

6.  1991 First Conference
 1993 First Kidney International publication
 1994 NEPHROL First websites and Email groups
 1995 Integration with CADI
 1997 Integration with CCTT classification, NKF cyberNephrology and ISN
Informatics Commission Formed
 1999 Second KI paper. Clinical practice guidelines. Implantation biopsies.
 2001 Classification of antibody-mediated rejection: Regulatory agencies
participating
 2003 Genomics focus, ptc cell accumulation scoring
 2005 Gene chip analysis. Elimination of CAN, identification of chronic
antibody-mediated rejection.
 2007 First meeting far from a town called “Banff” – La Coruna, Spain.
 2009 Working groups. Meeting in Banff, Alberta, Canada
 2011 Technology and Future of Medicine Course created LABMP 590
 2013 Establishment of Banff Foundation for Allograft Pathology

7. Significance of ‘Banff papers’
• 4244 citations of the 9 Banff meeting reports
• 790 Banff / Transplantation papers in PubMed
• Banff 2003 meeting report (ABMR criteria) = most cited AJT
paper
• 3 Banff meeting reports are among the top 4 cited AJT articles

8. Organizational structure of the Banff Foundation For Allograft Pathology
Board of Trustees:
K. Solez (Chair), L. Racusen, D. Glotz, J. Demetris, M. Mengel, M. Mihatsch, D. Seron, N.
Schmidt
2015 Local Conference
chair: Michael Mengel
Organ Steering committee
Chairs:
Composite tissues: Linda Cendales
Heart : Rene Rodriguez
Kidney: Mark Haas
Liver: Jake Demetris
Lung: William Wallace and Carol
Farver
Pancreas: Cinthia Drachenberg
Banff Working Group (BWG) Leads:
Molecular transplantation pathology: Michael Mengel, Banu Sis
Isolated v-lesions: Banu Sis, Ed Kraus
Quality assurance in transplantation diagnostics: Michael Mengel and
Parmjeet Randhawa
C4d-negative ABMR: Mark Haas, Banu Sis, Alexandre Loupy
Fibrosis scoring: Robert Colvin, Brad Farris, Michael Mengel
Digital Pathology in Transplantation: Jake Demetris
2015 Scientific program committee:
Alex Loupy (Chair)
Mark Haas, Banu Sis, Kathryn Tinkham, Candice
Rofousse, Chris Bellamy, Lynn Cornell, Carmen
LeFaucheur
Composite tissues: Linda Cendales
Heart : Rene Rodriguez
Liver: Jake Demetris
Lung: William Wallace and Carol Farver
Pancreas/Islets: Cinthia Drachenberg and John
Papadimitriou
Secretary/Treasurer:
Michael Mengel
funding
collaboration
reports to
reports to
collaboration
collaboration
reports to
collaboration
progress
reports to Budged
proposal and
accountability
for meeting
costs
support

11. Target Audience for the 2015 joint
CST/Banff meeting: total ~600 expected
delegates
 Basic Scientists
 Pathologists
 Immunogeneticists and HLA experts
 Transplant Physicians: Internal Medicine, Surgery,
Infectious Diseases, Critical Care
 Allied Health Care
 Students, Trainees, Fellows

12. The Banff Process
Consensus communication in renal transplantation
a
The Banff
lesions
g, i, t, v - score
The Banff
community
Pathologists
Nephrologists
Tx-Surgeons
Lab-Medicine
established by
consensus in 1991
The Banff
classification
Current consensus for
diagnostics
moderated
Banff meetings
thesis-antithesis-synthesis
tentative
thresholds
participate
refinementBanff Working
Groups
Feedback concerning weaknesses and strengths by results
from independent research
New members
Biostaticians
Molecular Biologists
“Omics”-specialists
Off-springs
Liver
Pancreas
Lung, Heart
CTA

13. The Banff Schema was first developed
at a meeting of pathologists, clinicians
and surgeons in Banff, Alberta, Canada,
August 2-4, 1991 and has become the
worldwide standard for the interpretation
of transplant biopsies.

14. The Banff Schema was first developed
at a meeting of pathologists, clinicians
and surgeons in Banff, Alberta, Canada,
August 2-4, 1991 and has become the
worldwide standard for the interpretation
of transplant biopsies.

16. Unique
Course on
Technology
and the
Future of
Medicine
LABMP 590
Created in
2011

17. Moore’s Law&Eroom’s Law , the
technological Singularity and
exponential change, exponential
decline in # new drugs per
billion dollars R&D expenditure.

18. Moore’s Law Predicts Singularity

19. The Technological
Singularity

20. Soft Transhumanism
– Ross Lockwood
The last decade has brought a profound change in the
way we humans interact. Our imagined future of merger
between human and electronic interface has crept into
our lives; social networks, adept at instantaneous byte-
sized communications, now permeate the younger
generations. There is still a chasm between hard-
Transhumanism, and this soft-Transhumanism, defined
by our interactions with personal electronics, but there
is no sign of these interactions abating. Fully embracing
this technological revolution, within the University
classroom and beyond, is beneficial to the learning
experience and to our cultural growth as human
beings.– Ross Lockwood HI-SEAS sMars mission May 4, 2014!

21. The Technological Singularity
The technological singularity occurs as artificial
intelligences surpass human beings as the smartest
and most capable life forms on the Earth.
Technological development is taken over by the
machines, who can think, act and communicate so
quickly that normal humans cannot even comprehend
what is going on. The machines enter into a "runaway
reaction" of self-improvement cycles, with each new
generation of A.I.s appearing faster and faster. From
this point onwards, technological advancement is
explosive, under the control of the machines, and
thus cannot be accurately predicted (hence the term
"Singularity"). – Ray Kurzweil

23.  All natural disease may be eliminated, leaving
only man-made diseases. But that may leave
as much for physicians to do as there is today!
 Challenging responses to bioterrorism and
stem cell technologies.
 Focus of medicine no longer disease but
enhancement, elevating the human condition,
which will extend beyond the physical to the
moral and spiritual.
 Social responsibility an important aspect of
medicine and one of the focuses of the course.
2045 is only 31 years from now. Many of you
will still be working then. What will medical
careers be like then?

24. Focus Groups
in May 2011
Course conceptualized in
March 2011, tested with
focus groups in
May for its suitability as a
course for both
undergraduate and
graduate students.

25. Over Time Our Course’s Sessions Have
Developed a Pedagogical Rhythm,
Leading To A Self-organized Structure
 Ten minute introduction
 Fifty minute lecture
 Twenty minute discussion
 In the course we talk about
machines replacing many of the
functions of human beings. This
picture was taken by a machine
without human intervention, as
were many of the best still
images from the course. The
video camera is constantly
comparing the scene to
algorithms and takes still
pictures when the requirements
of the interesting picture
algorithm are satisfied.

26. Video and Audio Quality Superb Now!
First teaching session 2011 Recent teaching session 2014
Hot-linked tables of contents in YouTube descriptions at
http://www.youtube.com/user/kimsolez allow one
to jump right to content of interest.

27.  Director of Social Media at Kandu Inc.
The Normal, Outgoing, Personable
Students in the Course are Little by Little
Changing the World!
Student Presentation Videos Have Had
Amazing Positive Effects!

28. Heather Graves, from Department
of English and Film Studies, in
Faculty of Arts. Diversity of views
and backgrounds is an important
feature of the course. Tech
skeptics represented.
Diverse Faculty from Across The
Campus Teach in the Course. All
Views Represented.

29.  We shoot broadcast quality video of each lecture
& discussion. http://www.singularitycourse.com
IT staff is intergral part of course, essential to it!
 Previous lectures at
http://www.youtube.com/user/KimSolez .
Students critique one past lecture, and suggest
improvements in presentation and hot-linked
table of contents (20% of grade).
 Students write one 3,000 word paper (40%) and
give 20 min. presentation on same subject
(30%). Also graded on class participation (10%).
 No required reading. Suggested reading list in
course outline, readings suggested by Email.
Course Specifics

30.  The technological Singularity. Existential
risks, AI, genomics, and nanotech.
 Ways to optimize a positive outcome for
humanity in the co-evolution of humans
and machines . The influence of these
considerations on medicine of the future.
 Dean of Science speaking, prominent
people internationally. Most lectures not
very “medical”. Easily understood.
 Balanced view provided by incorporating
both tech skeptics and tech advocates.
Course Content

31.  Medical student elective participation in course, med student club.
 International peer review of YouTube videos, modifications made.
Two Quantum Biology lectures.
 Young person old person point counterpoint lecture January 30th,
Abdullah Saleh/Earle Waugh Medical Ethics in a World of
Robots(What will we allow when everything is possible).
 Collaboration with Disruptive Technologies in Medicine course in
Budapest, Hungary, the only other course somewhat like this one.
 Accommodation for the shy student, working directly with
videographer for final presentation, texting questions.
 Space orientation, 3D printing in space, usability
of iOS devices in space, Mars habitat simulation,
analog space missions in context.
Other Innovations New in 2014

32. The Banff Foundation for Allograft Pathology
Must Remain Youthful and Relevant for the
Future – Must Adapt, Plan for Changes
 As the field changes and stem-cell-grown organs replace
transplantation, the organization must change with it
 Transplantation may be loosing its luster but luster of the
Banff Foundation for Allograft Pathology can remain
strong.
 As an exercise in alternative realities I asked participants
to consider the very different life of David Crippen, my
counterpart in critical care medicine. We need to consider
changes that large!

33. The spectacular dynamics influencing the
pace of stem generation of organs replacing
transplantation in the future.
 There were YouTube videos (now removed) suggesting
that stem cell generation of complex organs in humans
would be routine by 2020. Problems of clotting, endothelial
loss, and cell type selection errors not mentioned.
 The dramatic slowdown of new drug approvals (Eroom’s
Law) by the FDA suggests that the FDA is ripe for
disruptive innovation. Has happened.
 However stem cell therapies may be the last area the FDA
will relax regulation in, as unproven bogus stem cell
therapies are causing widespread suffering and protection
of the general public is needed.

34.  Transplant
pathologists will also
become tissue
engineering
pathologists,
pathologists who
analyse organs grown
from stem cells. This is
not something beyond
us, we can adapt to a
work life that includes
stem cells.. Someone
needs to cross the
disciplines.

35. Turtles
All
the
Way
Down
abstrusegoose.com/155

36. Animal
Analogies
Limited.
Need Human
Alter Egos

37. CCM-L
Characters
Off-Topic
Discussions
NEPHROL
No Characters
No Off-Topic
Discussions

38. Many Military
Awards, Karate
Black Belt
No Civilian Awards
Never Served in
Military
Many Civilian
Awards

39. Rock Band
Motorcycles
Colorful History in
60’s and 70’s
No Band or
Motorcycle
Boring Young Person

40. Crippen A
Myth?
Proves the
Metaphor
Works!