The Banff Working Group on Liver Allograft Pathology reviewed and discussed literature evidence regarding antibody-mediated liver allograft rejection at the 11th (Paris, France, June 5-10, 2011), 12th (Comandatuba, Brazil, August 19-23, 2013), and 13th (Vancouver, British Columbia, Canada, October 5-10, 2015) meetings of the Banff Conference on Allograft Pathology. Discussion continued online. The primary goal was to introduce guidelines and consensus criteria for the diagnosis of liver allograft antibody-mediated rejection and provide a comprehensive update of all Banff Schema recommendations. Included are new recommendations for complement component 4d tissue staining and interpretation, staging liver allograft fibrosis, and findings related to immunosuppression minimization. In an effort to create a single reference document, previous unchanged criteria are also included.

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H epatitis C virus (HCV), a member of the Flaviviridae family of RNA viruses, is characterized by genetic heterogeneity. At least 6 major HCV genotypes are identified. 1,2 Each genotype differs from the others by 30%-35% of its nucleotide site sequence and also exists as numerous genetically distinct isolates. [1][2][3] Each HCV genotype is unique with respect to its nucleotide sequence, geographic distribution, and response to therapy. 3 Thus, each genotype can be considered a phylogenetically distinct entity requiring its own specific clinical appreciation. Knowledge of the epidemiology of HCV genotypes is essential not only for epidemiological reasons but also from a clinical standpoint. The infecting HCV strain is known to be one of the main independent factors that influence the outcome of antiviral therapy. 2,3 Genotypes 1, 2, and 3 are common throughout the United States and Europe 2,4 and have thus become the focus of much interest and research. The clinical presentation and management of infections arising from these viral genotypes has advanced rapidly. In contrast, genotypes 4, 5, and 6 have not been adequately studied; therefore, the management strategies for patients infected with these genotypes are not as well developed. 4,5 HCV genotype 4 (HCV-4) is common in the Middle East and in Africa, where it is responsible for more than 80% of HCV infections, and has recently spread to several European countries. 4,5 Egypt has the highest prevalence of HCV worldwide (15%) 6 and the highest prevalence of HCV-4, which is responsible for almost 90% of infections and is considered a major cause of chronic hepatitis, liver cirrhosis, hepatocellular carcinoma, and liver transplantation in the country. [5][6][7] Although HCV-4 is the cause of approximately 20% of the 170 million cases of chronic hepatitis C in the world, it has simply not been the subject of widespread research; therefore, the features of this genotype and management strategies for patients infected with this genotype are not as well developed as for