Looking Back: Reflections on Banff 1991 From Banff 2003

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Looking Back Reflections on Banff 1991 From
Banff 2003

• Douglas R. Wilson, M.D.

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Statement in 1991 Why Banff? Searching for the
muse!

• The Muses were nine goddesses of the arts and
  sciences in Greek mythology.
• The Muses lived on Mount Olympus with their
  leader, the god Apollo. Like him the Muses
  remained young and beautiful forever.
• They could see into the future, which few other
  gods could do. They also had the ability to
  banish all grief and sorrow. The muses had
  pleasing melodic voices and often sang as a
  chorus.
• Early Greek writers and
  artists called on the muses
  for inspiration before
  beginning to work.

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The Nine Muses

• Any or all of the muses could be asked for
  assistance even though each governed a specific
  art or science
• Calliope Muse of epic poetry
• Erato Muse of love poetry
• Euterpe Muse of lyric poetry
• Melpomene Muse of tragedy
• Thalia Muse of comedy
• Clio Muse of history
• Urania Muse of astronomy
• Polyhymnia Muse of sacred song
• Terpsichore Muse of dance

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We call on CLIO The MUSE of HISTORYAndTHALIA
The MUSE of COMEDYOut of DisasterandFrom the
Heartcame BANFF !!
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• 1989 - International Society of Nephrology
  launched the ISN Commission on Acute Renal
  Failure, chaired by Kim Solez, with a focus on
  disaster relief, in response to the disorganized
  international approach to the earthquake in
  Armenia
• 1990 Published work on standardization of
  nomenclature for the diagnosis of heart and lung
  transplant rejection.

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• 1991 - August 2-4 First Banff meeting organized
  by ISN Commission to include a meeting of the
  Disaster Relief Task Forceand
• Workshop on International Standardization of the
  Nomenclature and Criteria for the Histologic
  Diagnosis of Kidney Transplant Rejection
• Its no wonder that it came to be called the
  Banff schema !!

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Notable Features of first Banff meeting included

• Good advance work (Croker,Olsen, Racusen, Solez)
• Small size - about 20 participants
• Mix of pathologists and transplant clinicians
  (7-8 of each, and largely in teams from the same
  center)
• International involvement Canada (2), USA (3),
  Denmark, Finland
• Fine arts accompaniment recitals and Cosi fan
  Tutte - the Muses of Poetry, Dance and Song

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The way we were! Movies from 1991 courtesy of
Phil and Ginny Halloran!
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Video Clip from Banff 1991
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LOTS OF FOLLOW-UP WORK by phone, fax, meetings
and correspondence to

• greatly widen the circle of those involved
• circulate sets of slides for panel assessment
• publication of Banff schema in high quality
  international journal (Kidney International 44
  411-422,1993)
• with inclusive authorship USA (10 centers),
  Canada (3), UK (1), Denmark (1), Finland (1),
  Switzerland (1), and Japan (2)

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Maintain Momentum A work-in-progress for 12
years

• Bi-Annual meetings
• 1993, 1995, 1997, 1999, 2001 at
• Banff Springs Hotel and Rimrock Resort
• Active involvement of liver transplant
  pathologists and clinicians
• Widespread use of the classification in world
  wide sites and in clinical trials of
  immunosuppressive regimens

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• Ability to achieve agreement on changes based on
  other schema 1997 Collaborative Clinical
  Trials in Transplantation (CCTT)
• Regular, significant, and inclusive publications
• Kidney International 55 713-723,1999
• (27 centers) and
• Am. J Transplantation 31-7,2003
• (24 centres)

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Much has been accomplished, Much has been
learned

• orWhat does it take to get 41 pathologists and
  clinicians to collaborate ??over a long time !
• Lessons Learned 6 Success Factors
• Common cause that has obvious importance and
  practical value-added
• A loose tight organization inclusive,
  flexible, but goal-driven. Function is more
  important than structure!

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• Collaboration of pathologists and clinicians is
  critical (or.. It is easier for pathologists to
  agree if there are simple clinicians involved
  with them
• Committed champions willing to push the process
  of collaboration over extended time period
• Willingness of all to share the credit
• Pleasure and satisfaction of working and having
  fun with international colleagues

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Here is a Toast to the melodic voices of the
chorus of Muses !!