Evolution of human kidney allograft pathology diagnostics through 30 years of the Banff classification process

Core Tip

Core Tip: The efforts to standardize the nomenclature, classification, and reporting of kidney allograft biopsies were initiated in 1991 by a small group of renal pathologists, transplant physicians, and surgeons at a meeting in Banff, Alberta, Canada. Thereafter, regular meetings of the now ever-expanding, multidisciplinary, and international Banff community have been held every 2 years at different places around the world to revise, update and refine the classification. Major and frequent changes have occurred in the classification over the three decades of its evolution, making it extremely complex and difficult to comprehend, particularly for beginners in the field. The classification has essentially changed from pathology-based to pathogenesis-based classification and has become clinician-friendly and treatment-friendly. This review is an attempt to summarize the changes in the classification in an easily understandable manner and describe the rationale behind these changes for easy assimilation by both neophytes and practicing renal pathologists, transplant physicians, surgeons, and other relevant stakeholders.