The XVth Banff Conference on Allograft Pathology meeting was held on September 23-27, 2019, in Pittsburgh, Pennsylvania, USA. During this meeting two main topics in cardiac transplant pathology were addressed: 1 - Improvement of endomyocardial biopsy accuracy for the diagnosis of rejection and other significant injury patterns. Molecular technologies have evolved in recent years, deciphering pathophysiology of cardiac rejection. Diagnostically, it is time to integrate histopathology of EMBs and molecular data. The goal is to incorporate molecular pathology, performed on the same paraffin block as a companion test for histopathology, to yield more accurate and objective EMB interpretation. Application of digital image analysis from H&E stain to multiplex labelling is another means of extracting additional information from EMBs. New concepts have emerged exploring the multifaceted significance of myocardial injury, minimal rejection patterns supported by molecular profiles, and lesions of arteriolitis/vasculitis in the setting of TCMR and AMR. 2 - The orphaned lesion known as Quilty effect or nodular endocardial infiltrates. A state-of-the-art session with historical aspects and current dilemmas reviewed, possible pathogenesis proposed, based on advances in immunology to explain conflicting data. Quilty effect will be the subject of a multicenter project to explore whether it functions as a tertiary lymphoid organ.
View details for DOI 10.1111/ajt.16083
View details for PubMedID 32476272