Banff Classification for Kidney Transplant Rejection
Translate kidney allograft biopsy lesion scores into a Banff rejection category (antibody-mediated rejection, T-cell-mediated rejection, borderline changes, and chronic lesions) so nephrologist and pathologist agree on one diagnosis.
When to use it
Use when interpreting a kidney transplant biopsy to assign a Banff category, communicate findings consistently across the transplant team, and guide anti-rejection therapy.
Category
Transplantation
References
- Loupy A et al. Am J Transplant. 2020;20(9):2305-2331
- Mengel M et al. Am J Transplant. 2024;24(4):557-570 — Banff 2022 meeting report
- Haas M et al. Am J Transplant. 2018;18(2):293-307
Common clinical questions
- What is the difference between borderline changes and TCMR on Banff?
- Borderline changes show tubulitis with minor or no interstitial inflammation that falls short of the threshold for T-cell-mediated rejection. Whether to treat borderline changes depends on graft function, donor-specific antibodies, and dd-cfDNA; established TCMR meets the interstitial-inflammation and tubulitis thresholds and is treated with corticosteroids.
About NephroMind
This calculator is part of NephroMind, a free clinical decision-aid platform from the Arab Society of Nephrology and Renal Transplantation (ASNRT) — over 129 bedside nephrology calculators plus a renal drug-dosing database, coded by a practicing transplant nephrologist.