The Banff 97 working classification refines earlier schemas and represents input from two classifications most widely used in clinical rejection trials and in clinical practice worldwide. Major changes include the following: rejection with vasculitis is separated from tubulointerstitial rejection; severe rejection requires transmural changes in arteries; "borderline" rejection can only be interpreted in a clinical context; antibody-mediated rejection is further defined, and lesion scoring focuses on most severely involved structures. Criteria for specimen adequacy have also been modified. Banff 97 represents a significant refinement of allograft assessment, developed via international consensus discussions.

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Renal biopsies from 21 patients with minimal change nephrotic syndrome and mesangial IgM deposits were investigated by means of fluorescence, light and electron microscopy; elution of tissue-bound antibody; and fixation of heterologous (guinea pig) complement. In 12 patients complement and IgM deposits were associated and, in 4 of these, electron dense deposits conforming to immune complexes were detected in mesangia. Antibody elution and heterologous complement fixation studies in tissues suggested that such immune reactants may represent interaction of complement-fixing antibody and antigen. Long-term follow-up studies are needed to determine the clinical relevance of IgM deposits in minimal change nephrotic syndrome.