Kim Solez reflects on the state of the Technology and Future of Medicine LABMP 590 course at the University of Alberta a year after its conception. Copyright (c) 2012 by Transpath Inc.

1. A year after the conception of the
Technology and Future of Medicine Course (LABMP
590) it is useful to reflect on its progress and
evolution.

2. Course conceptualized in
March 2011, tested with
focus groups in
May for its suitability as a
course for both
undergraduate and
graduate students.

3. “Unleash your inner radical. Do it now. There are no crazy ideas.” President
Indira Samesekera

4. The zeal and student enthusiasm
for our course is now driving the
production of a book with a new
title,
Technology and the Future – A
Manifesto
that is in turn now coevolving with
the course.

5. The book will be published on
all significant Internet-mediated
platforms including: Kindle,
Nook, Vook, Sony Reader, Kobo,
and Apple iBook (IOS).

6.  Ten minute introduction
 Fifty minute lecture
 Twenty minute discussion

7. Heather Graves, from Department
of English and Film Studies, in
Faculty of Arts.

8. First teaching session 2011 Recent teaching session 2012

9. 1. Increase course enrollment both externally and locally
2. Add additional topics to broaden multidisciplinary nature
of course still further
3. Replicate course widely elsewhere
4. Masters student in College of Pharmacy, Qatar
University, Doha, Qatar joining us by Skype

10. 1) How I came to create this course
2) How it fits into my career path
3) How it relates to Banff Allograft Pathology Consensus
Process and Nepal Initiative
4) How it relates to Future of Pathology

11. 1) In 1994 created websites for CAP, ISN, and RPS and NEPHROL
Email discussion group
2) In 1997 created NKF CyberNephrology and ISN Informatics
Commission
3) In 1999 new Lab Medicine Pathology chair, Victor Tron,
suggested I broaden focus to CyberMedicine, and encouraged
medical humanitarian ventures

12. 1) In 2007 joined medical advisory board of new medical school in
Nepal devoted to rural health, Patan Academy of Health
Sciences (“PAHS”).
2) Now co-direct fundraising and public relations for PAHS, ten
UofA faculty are now involved in the project.

13. 1) Tech musings from the Hinterland. Virtual microscopy one topic.
2) The first video was from Nepal.

14. Singularity
Course

15.  In February 2011
began writing book
on the same day
the Singularity
appeared on the
cover of Time
magazine.

16.  In 1990 all standard textbooks were inaccurate in
interpretation of kidney transplant biopsies
◦ Suggesting, for example, that arteritis meant that the
kidney was doomed and antirejection treatment should
be abandoned
 It became imperative for the field to correct this
and standardize interpretation
Singularity
Course

17.  .
The Banff Schema
was first developed
by a group of pathologists, nephrologists,
and transplant surgeons at a meeting
in Banff Canada August 2-4, 1991..
It has continued to evolve through meetings every
two years and has become the worldwide standard for
interpretation of transplant biopsies

18. • Began in kidney (Solez
et al. 1993), and was
then extended to
liver, pancreas, compo
site tissue grafts etc.
Meetings also
consider
heart, lung, small
bowel.
• Uses semi-
quantitative lesion
scoring 0-3+ and
diagnostic categories.

19.  A principal investigator in Phil Halloran‟s 18 Million
Dollar Genome Canada
transplant transcriptome project.
Affymetrix GeneChip® probe array.
Image courtesy of Affymetrix.
 The prime mover behind the Banff
Conferences and Classification
which mainly uses techniques of thirty to fifty years
ago. BANFF Cybernephrology

21.  1991 First Conference
 1993 First Kidney International publication
 1995 Integration with CADI
 1997 Integration with CCTT classification
 1999 Second KI paper. Clinical practice guidelines. Implantation
biopsies, microwave.
 2001 Classification of antibody-mediated rejection
◦ Regulatory agencies participating
 2003 Genomics focus, ptc cell accumulation scoring
 2005 Gene chip analysis. Elimination of CAN, identification of chronic
antibody-mediated rejection.
 2007 First meeting far from a town called ―Banff‖ – La Coruna, Spain.
 2009 Working groups. Meeting in Banff, Alberta, Canada for last time until
2017!
Singularity
Course

22.  Normal
 Antibody-mediated rejection,
 Borderline changes: „Suspicious‟ for acute
cellular rejection
 T-cell-mediated rejection (may coincide
with categories 2 and 5 and 6)
 Sclerosis, interstitial fibrosis, and tubular
atrophy, no evidence of any specific etiology
 Other changes not considered to be due to
rejection

23.  Transplant glomerulitis - g
 Chronic transplant glomerulopathy - cg
 Interstitial Inflammation - i (ti)
 Interstitial fibrosis - ci
 Tubulitis - t
 Tubular atrophy - ct
 Vasculitis, intimal arteritis - v
 Fibrous intimal thickening - cv
 Arteriolar hyaline thickening - ah (aah)
 Mesangial matrix increase - mm
 Peritubular capillary cell accumulation - ptc
Singularity
Course

24.  Classification begun at 1991 Banff meeting has
become the worldwide standard, and the
consensus process has now extended to all solid
organs. Meetings continue every two years. Latest
meeting was in Paris in June 2011.
 Future meetings are planned every two years
through 2019.
 Standardization principles now being extended
from biopsy reporting to tissue typing, imaging, all
the other elements in transplant care.
Singularity
Course

25.  2013 – Campos do Jordao, Sao Paulo, Brazil
 2015 – Istanbul, Turkey
 2017 – Banff, Alberta, Canada.
 2019 – Barcelona, Spain
 2021– Make a proposal!
Singularity
Course

27.  Like the mosh pit at a
great rock concert. No
partner, the ultimate in
individuality, dangerous
, but when the music is
good everyone dances
in sync and life is good!

28. • Until now we have
had none beyond
Drs. Racusen and
Solez.
• Plan to form Swiss
foundation, a legal
entity, in 2012.

29.  It is hard to believe we
have been at this for
twenty years!
Images from 1991

31.  Despite a primitive beginning 21
years ago all the high tech ideas
we talk about in this course are
infusing their way into the Banff
consensus process &
meetings—completing the cycle