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A Brief Update from the Pathology Council

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Brandon T. Larsen, MD, PhD
Mayo Clinic Arizona
Scottsdale, AZ, USA

The Pathology Council has been busy in 2016. As in recent years, antibody-mediated rejection (AMR) has remained a strong focus of our Council's efforts as we seek to better understand the phenomenon of AMR and the nature of "mixed rejection", to refine our diagnostic criteria and relevant biomarkers for such, and to disseminate this information to pathologists. To this end, the Council put together several collaborative research groups this year during the last Annual Meeting to facilitate multi-center studies on these topics, and our members continue to expand available online resources for transplant pathology.

Pathology Council Initiatives

First, the Council has established a working group to investigate inflammatory burden in cardiac AMR. Gerry Berry together with Ornella Leone, Annalisa Angelini, Patrick Bruneval, and Jean Paul Duong Van Huyen are discussing a protocol, and will invite other centers to participate. Second, the Council has agreed to look at potential markers of chronic rejection in our biopsies, learning from experiences gained in other solid organ transplants. A small group has been put together to discuss a possible protocol, with the intent of setting up another collaborative multi-institutional study. This group includes Martin Goddard, Elizabeth Hammond, Bobby Padera, and Annalisa Angelini. In addition, other research and educational initiatives have also been proposed, and although these are in their infancy, we can certainly expect more to come. Stay tuned for updates and invitations to join these collaborative efforts.

Members of the Pathology Council also continue to be engaged in concerted efforts to develop better online tools for transplant pathology. In recent years, members of our Council have developed and are continually updating an online tutorial on cardiac ACR and AMR for pathologists, including online quiz components, in partnership with the Society for Cardiovascular Pathology and Association for European Cardiovascular Pathology (http://scvp.net/acr/index.html). This online tutorial continues to be well received, but any suggestions for improvement that you might have would be welcomed.

Not to be outdone, pulmonary pathologists have also begun to develop online tools to aid pathologists in interpretation of lung transplant biopsies. This year, our European colleagues led by Fiorella Calabrese have developed a tutorial website for pulmonary AMR, hosted by the European Society of Pathology (http://lungtransplant.dctv.unipd.it/amr/index.php). This website is a work in progress, and eventually will include all aspects of lung transplant pathology. If you encounter good examples of diagnostic grades of rejection or other entities in lung transplant pathology that could be included in this online resource, please contact Fiorella Calabrese at fiorella.calabresse@unipd.it.

One of the Pathology Council's ongoing challenges remains dissemination of knowledge about the practical application of rejection criteria to practicing pathologists on the "front lines," many of whom are not ISHLT members and most of whom evaluate these specimens as a small component of their broader duties in surgical pathology. The ISHLT Board is keen that we continue to engage with our pathology colleagues, including those who are non-members. We urge our Council members to continue reaching out to pathologists in other centers who practice transplant pathology, to keep them informed and to encourage them to consider joining us. Pathology remains an under-represented specialty in the ISHLT and we would all benefit from adding more members. There is considerable expertise in transplant pathology out there among non-members that remains untapped! Please spread the word.

2017 Annual Meeting & Scientific Sessions in San Diego, CA.

Perhaps the most important news related to the upcoming Annual Meeting in 2017 for busy pathologists is a change in the format of the Annual Meeting. Beginning with this next meeting, program content relevant to the Pathology Council will be clustered into a single day (Friday, April 7), instead of being distributed throughout the entire meeting over several days. Hopefully this concentration of program content will shorten the time away from our practices and allow more of our members to attend. Please spread the news to your pathology colleagues, especially the ones who may have been interested in the past but couldn't attend due to time constraints. In any case, you won't want to miss our exciting pathology-oriented sessions in San Diego next spring.

For more details about the upcoming Annual Meeting, please keep your eyes on the ISHLT website at http://www.ishlt.org/meetings/annualMeeting.asp. The preliminary Scientific Program should be released very soon.

See you all in San Diego!

Disclosure Statement: The author has no conflicts of interest to disclose.

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