Kim Solez 204 years of banff spirit 8 new august 24 2018

1. Kim Solez World Exponential Timeline
From Homer Smith 1895 to Aug. 7, 2099
1934 Leonard
Cohen
1941 Paul Simon 1945 Rod Stewart 1991 Ed Sheeran
1994 Mallory Chipman
1901 Louis
Armstrong
1920 Robert
Heptinstall
1943
Janis
Joplin
1961 Peter
Diamandis

2. Think Different
It is different to mix
science, music, and
poetry together as
we have done in this
presentation!

3. Think Different – Kim Solez sharing
cyberNephrology 5B3.09 WCM HSC with
Students & Fellows
Annette Shaff / Shutterstock.com

4. 204 Years of the Spirit of Banff 1895-2099 122
Back 82 Forward

5. Homer Smith, born 1895, turned Kim on to the
kidney in med school 3rd yr.

6. Homer Smith born 1895 Turned me on to
kidney in med school 3rd year .

7. Louis Armstrong, born 1901, Turned Kim on to
the trumpet and jazz.

8. Robert Heptinstall, born 1920, was Kim Solez’s
mentor in renal pathology

9. Solez, Morel-Maroger, and Sraer
Medicine 58:362-376, 1979. Morphology
of "acute tubular necrosis" in man:
Analysis of 57 renal biopsies and
comparison with the glycerol model. My
most cited paper before coming to
Edmonton as Chair of Pathology.

10. Solez, Morel-Maroger, and Sraer
Medicine 58:362-376, 1979
1. Of the 12 lesions assessed in the 57 “ATN”
biopsies 10 persisted after functional
recovery. Only 2 lesions correlated with
function, were present when renal failure
was present and absent after recovery:
1)thinning of PAS positive brush border, & 2)
shedding of individual tubular epithelial cells
leaving bare basement membrane.

11. Solez, Morel-Maroger, and Sraer
Medicine 58:362-376, 1979
2. Lesions which persisted after recovery of
function included tubular dilation, regeneration,
mitoses, casts, interstitial edema, inflammation,
nucleated cells in vasa recta, dilation of
Bowman’s capsule, tubularization of Bowman’s
capsule epithelium, & juxtaglomerular
apparatus hyperplasia. The latter two were
more prominent in recovery biopsies.

12. Solez, Morel-Maroger, and Sraer
Medicine 58:362-376, 1979
3. Lumping all acute tubular injury lesions
together guarantees that histology assessment
will appear to be inferior to molecular
assessment, since the majority of ATI lesions
persist after functional recovery. Only studies
which separately assess the two lesions which
correlate functionally are valid. i.e. 1)thinning or
absence of PAS positive brush border, & 2)
shedding of individual tubular epithelial cells .

13. Paper still referred to in recent reviews,
findings uncontested.
Basile et al., 2012

14. Cannot say molecules change faster than
morphology until you look at these two
lesions, BB loss and cell exfoliation!
Basile et al., 2012

15. Heptinstall called the 1979 paper ”the
best that can be done with a difficult
subject!”

16. Later work on Transplant Acute Tubular Injury
Was an Important Antecedent to Banff Studies
1993 KI paper on Transplant ATI.

17. New insights into transplant ATN, Solez et al. 1993
Brush border loss not a feature of transplant ATN.

18. Forty years later a more nuanced
understanding of the post ischemic kidney
is that tubular injury and microvascular
injury are separable components which
can be influenced in opposite ways by
pharmacologic interventions. Both types
of injury contribute to renal functional
impairment. These issues are the subject
of major precision medicine initiatives
which should bear fruit in 2019-2020.

19. Leonard Cohen, born 1934, turned Kim on to
poetry and his style of music

20. Nine months after meeting Kim Solez over 3 day
weekend in 2005 Leonard wrote song inspired by
their discussion of Banff borderline changes.

21. Ten years later Leonard removed all but one of the
borderlines and the song became the popular
“Treaty” on the 2016 You Want It Darker album.
“I wish there was a treaty we could sign
I do not care who takes this bloody hill …
I wish there was a treaty we could sign
It’s over now the water and the wine
We were broken then but now we’re borderline
I wish there was a treaty
I wish there was a treaty
Between your love and mine”
The notebook pages showing this ten year song transition were the
only such pages reproduced in the program for the “Tower of Song”
Tribute Concert in Montreal at the Bell Centre November 6th, 2017.

22. Paul Simon, born 1941, has inspired Kim with
his lyrics for a long time

23. Janis Joplin, born 1943, inspired Kim and was a
friend of Leonard Cohen

24. Rod Stewart, born 1945, inspired
Kim Solez and Lorraine Racusen

25. Kim Solez, born 1946, already plotting things at
age 3 seen here with father.

26. His first memory of event impacting outside world,
age 7: Hearing Queen Elizabeth Coronation on
Radio in 1953

27. The Origin of Kim’s Diversity Beliefs at Age 7,
Yasmini.

28. Which Led to This 2008 Essay

30. Ray Kurzweil, born 1948, co-founder of Singularity
University, is Kim Solez’s most important technology
influence.

31. Peter Diamandis, co-founder of Singularity
University born in 1961, is an important technology
influence.

32. Ed Sheeran, born in 1991, is an important
musical influence on Kim.

33. Banff Transplant Pathology
Classification Began at The
TransCanada Pipeline Pavilion at the
Banff Centre for Conferences in 1991

34. Banff meeting slide box mentioned in
first Banff abstract in 1991 is in itself
also an important player in story .

35. Ironically the last Banff classification
workshop in which these slides were
used was in 2004 in Aleppo, Syria.

36. Mallory Chipman, born 1994, is an
important musical collaborator in
technology&Leonard Cohen events!

37. Kim&Mallory initiated Technology&All
That Jazz Project to broaden the reach
of important ideas in science.

38. So where will it end? The farthest
future date in song Kim Solez can
conceptualize is Aug. 7, 2099

39. So where will it end? The farthest
future date in song Kim Solez can
conceptualize is Aug. 7, 2099

40. So where will it end? The farthest
future date in song Kim Solez can
conceptualize is Aug. 7, 2099

41. We have ended the timeline with Aug.
7, 2099, and will create an event page
but then again there is also this song!

42. So maybe we have to push our
imaginations to 5555. Kim Solez can
imagine that Banff will still be
remembered in 2525, but not in 5555!

43. Kim Solez, MD

44. Pennan, Scotland near Banff is where
classic 1983 movie “Local Hero” was shot

45. Kim Solez with meeting coordinator Michele
Hales in 2002 in Pennan.

46. 2003 image from Aberdeen Banff meeting.
Lorraine Racusen is in the center and
Michele Hales is beside her. Phil Halloran is
behind Michele. Jake Demetris is at far left.

47. Tori Sheldon and Akshatha Raghuveer. In 2007 we
lost our funding from the NKF and student staffing
began.

48. Many students have contributed
extensively to Banff meetings.

49. Video has become an important part of
meetings, Patricia Bacus, Banff 2017

50. Nikki Olson was important part of early video
efforts and creation of Tech&Future of Medicine
course

51. Laurie Bennett also provided early videography
assistance to Kim Solez

52. In recent years Tatiana Zagorac has become
main videography advisor to Kim Solez

53. Another important local hero is the local
Banff meeting director, like Daniel Seron in
Banff 2017. The subject of another ppt!

54. Kim Solez, MD

55. In 1991 Kim Solez and Lorraine Racusen Directed the First Banff Meeting
Which Created the Banff Classification of Transplant Pathology and Banff
Consensus Process
Classification established, lesion scoring,
diagnostic categories, physician-led consensus

56. BANFF CLASSIFICATION STANDARD FOR
TRANSPLANT BIOPSY INTERPRETATION
Began in kidney (Solez et al. 1993), and was then extended
to liver, pancreas, composite tissue grafts etc. Meetings
also consider heart, lung, small bowel.
Uses semiquantitative lesion scoring 0-3+ and diagnostic
categories. A pathologic classification of all pathologic
changes, not just rejection.

57. 1993 Meeting was joint with Canadian
Association of Pathologists – Future
Consortium was Important Antecedent
1993 Meeting - Liver classification, chronic rejection, first presentation on
molecular pathology approaches, CAP Future of Pathology Consortium consensus discussions
1988-94 were an important antecedent to Banff consensus discussions .

58. 1995 Banff meeting at Banff Centre for
Conferences Group Picture of Liver Attendees

59. 1995 Shot - Bruce McManus in Center, Pekka Hayry
Behind, Fred Sanfillipo in Doorway - Who Else Can
You Identify?

60. More 1995 Shots
Kim Solez and Lorraine Racusen
1995 Meeting - Pancreas classification, glomerulitis, first international medical meeting on
CD-ROM, first Banff conference with microscope sessions. Lesion scoring normalized with CADI.

61. 1997 Meeting – Banff Springs Hotel
1997 Meeting - Merging of Banff and CCTT classifications, establishing basis for current Banff
classification, post-transplant lymphoproliferative disorder, first Banff conference with posters.

62. 1999 Meeting - Larry Hunsicker,
Agnes Fogo, and Elaine Solez
1999 Meeting - Protocol biopsies, chronic rejection, and viral diseases, clinical practice guidelines.
First conference supported by an NIH grant.

63. 1999 Meeting – Michael Kashgarian and Agnes
Fogo
1999 Meeting - Protocol biopsies, chronic rejection, and viral diseases, clinical practice guidelines.
First conference supported by an NIH grant.

64. 1999 Meeting – Glomerulitis Study Group with
Kiril Trpkov
1999 Meeting - Protocol biopsies, chronic rejection, and viral diseases, clinical practice guidelines.
First conference supported by an NIH grant. Glomerulitis study group.

65. 1999 Meeting – Agnes Fogo
1999 Meeting - Protocol biopsies, chronic rejection, and viral diseases, clinical practice guidelines.
First conference supported by an NIH grant. Glomerulitis study group.

66. 1999 Meeting – Larry Hunsicker,
Elaine Solez, and Agnes Fogo
1999 Meeting - Protocol biopsies, chronic rejection, and viral diseases, clinical practice guidelines.
First conference supported by an NIH grant. Glomerulitis study group.

67. 2001 Meeting – Larry Hunsicker,
Agnes Fogo, Kim Solez and Bob Colvin
2001 Meeting - AMR, donor biopsies, genomics, CAN, heart transplantation

68. 2001 Meeting – Parmjeet Randhawa and
Volker Nickeleit
2001 Meeting - AMR, donor biopsies, genomics, CAN, heart transplantation

69. 2001 Meeting – Peter Furness
2001 Meeting - AMR, donor biopsies, genomics, CAN, heart transplantation

70. 2001 Meeting – Lorraine Racusen
2001 Meeting - AMR, donor biopsies, genomics, CAN, heart transplantation

71. 2001 Meeting –
David Rush and Denis Glotz
2001 Meeting - AMR, donor biopsies, genomics, CAN, heart transplantation

72. 2003 Meeting –
J. Stewart Cameron and Andrew Rees
2003 Meeting - C4d, macrophages, tolerance, accommodation, immunodepletion

73. 2003 Meeting –
Andrew Rees
2003 Meeting - C4d, macrophages, tolerance, accommodation, immunodepletion

74. 2003 Meeting –
Doug Wilson
2003 Meeting - C4d, macrophages, tolerance, accommodation, immunodepletion

75. 2003 Meeting –
Sony Aibo Robotic Dog
2003 Meeting - C4d, macrophages, tolerance, accommodation, immunodepletion

76. 2003 Meeting –
Michele Hales and Janice McDonald
2003 Meeting - C4d, macrophages, tolerance, accommodation, immunodepletion

77. 2003 Meeting –
Lorraine Racusen and Family
2003 Meeting - C4d, macrophages, tolerance, accommodation, immunodepletion

78. 2005 Meeting – Phil Halloran, Ginny Halloran,
Vido Ramassar
2005 Meeting - Genomics and molecular markers, B cells, chronic allograft injury with
elimination of CAN, establishment of criteria for chronic rejection.

79. 2005 – Janice McDonald, Charlene Hunter,
Banu Sis, Michele Hales
2005 Meeting - Genomics and molecular markers, B cells, chronic allograft injury with
elimination of CAN, establishment of criteria for chronic rejection.

80. 2005 – Kim Solez and Banu Sis
2005 Meeting - Genomics and molecular markers, B cells, chronic allograft injury with
elimination of CAN, establishment of criteria for chronic rejection.

81. 2007 Meeting – Michele Hales and Eduardo
Martul
2007 Meeting - Protocol biopsies, transcriptome, mechanisms of rejection, ptc grading, new
total inflammation score; working groups for v-lesion, genomic integration, pancreas and
composite tissue rejection schemas

82. 2007 Meeting – Kunio Morozumi and Michael
Mihatsch
2007 Meeting - Protocol biopsies, transcriptome, mechanisms of rejection, ptc grading, new
total inflammation score; working groups for v-lesion, genomic integration, pancreas and
composite tissue rejection schemas.

83. 2007 Meeting – Banu Sis
2007 Meeting - Protocol biopsies, transcriptome, mechanisms of rejection, ptc grading, new
total inflammation score; working groups for v-lesion, genomic integration, pancreas and
composite tissue rejection schemas.

84. 2007 Meeting – Ian Gibson
2007 Meeting - Protocol biopsies, transcriptome, mechanisms of rejection, ptc grading, new
total inflammation score; working groups for v-lesion, genomic integration, pancreas and
composite tissue rejection schemas.

85. 2007 Meeting – Roz Mannon
2007 Meeting - Protocol biopsies, transcriptome, mechanisms of rejection, ptc grading, new
total inflammation score; working groups for v-lesion, genomic integration, pancreas and
composite tissue rejection schemas.

86. 2007 Meeting – Michael Mengel
2007 Meeting - Protocol biopsies, transcriptome, mechanisms of rejection, ptc grading, new
total inflammation score; working groups for v-lesion, genomic integration, pancreas and
composite tissue rejection schemas.

87. 2007 Meeting – Eduardo and Lorraine
2007 Meeting - Protocol biopsies, transcriptome, mechanisms of rejection, ptc grading, new
total inflammation score; working groups for v-lesion, genomic integration, pancreas and
composite tissue rejection schemas.

88. 2007 Meeting – Nikki Olson and
Kim Solez
2007 Meeting - Protocol biopsies, transcriptome, mechanisms of rejection, ptc grading, new
total inflammation score; working groups for v-lesion, genomic integration, pancreas and
composite tissue rejection schemas.

89. 2007 Meeting – Tori Sheldon, Nikki Olson and
Paula Blanco
2007 Meeting - Protocol biopsies, transcriptome, mechanisms of rejection, ptc grading, new
total inflammation score; working groups for v-lesion, genomic integration, pancreas and
composite tissue rejection schemas.

90. 2007 Meeting – Michael Mengel
2007 Meeting - Protocol biopsies, transcriptome, mechanisms of rejection, ptc grading, new
total inflammation score; working groups for v-lesion, genomic integration, pancreas and
composite tissue rejection schemas.

91. 2007 Meeting – Tori Sheldon and
Nikki Olson
2007 Meeting - Protocol biopsies, transcriptome, mechanisms of rejection, ptc grading, new
total inflammation score; working groups for v-lesion, genomic integration, pancreas and
composite tissue rejection schemas.

92. 2007 Meeting –Nikki Olson
2007 Meeting - Protocol biopsies, transcriptome, mechanisms of rejection, ptc grading, new
total inflammation score; working groups for v-lesion, genomic integration, pancreas and
composite tissue rejection schemas.

93. 2007 Meeting –Eduardo and
Lorraine and Richard Racusen
2007 Meeting - Protocol biopsies, transcriptome, mechanisms of rejection, ptc grading, new
total inflammation score; working groups for v-lesion, genomic integration, pancreas and
composite tissue rejection schemas.

94. 2007 Meeting – Dinner in Castle, Nikki Olson,
Tori Sheldon, and Bob Colvin
2007 Meeting - Protocol biopsies, transcriptome, mechanisms of rejection, ptc grading, new
total inflammation score; working groups for v-lesion, genomic integration, pancreas and
composite tissue rejection schemas.

95. 2009 Meeting – Jubilant Tori and Akshatha
Return to Edmonton!
2009 Meeting - Viruses, quality assurance, AMR in kidney, heart, and pancreas, liver allograft
accommodation, endothelial cells, surrogate markers. Working groups.

96. 2009 Meeting – Lorraine Racusen and Michael
Mengel
2009 Meeting - Viruses, quality assurance, AMR in kidney, heart, and pancreas, liver allograft
accommodation, endothelial cells, surrogate markers. Working groups.

97. 2009 Meeting – Mark Haas
2009 Meeting - Viruses, quality assurance, AMR in kidney, heart, and pancreas, liver allograft
accommodation, endothelial cells, surrogate markers. Working groups.

98. 2009 Meeting – Jubilant Dar, Akshatha and Tori
Head Back to Edmonton!
2009 Meeting - Viruses, quality assurance, AMR in kidney, heart, and pancreas, liver allograft
accommodation, endothelial cells, surrogate markers. Working groups.

99. 2011 Meeting – Larry Hunsicker, Agnes Fogo,
and Kim Solez
2011 Sensitized patient, C4d, isolated v-lesion, the future, genomics, glomerulitis, epithelial injury
/epithelial mesenchymal transformation, operational tolerance monitoring in liver grafts.

100. 2011 Meeting – Banu Sis Isolated V
2011 Sensitized patient, C4d, isolated v-lesion, the future, genomics, glomerulitis, epithelial injury
/epithelial mesenchymal transformation, operational tolerance monitoring in liver grafts.

101. 2013, 2015, and 2017 – Recent so you have
your own favorite images!
Kim Solez’s favorite image from Banff 2017 capturing the spirit of Banff!

102. Banff 2019 and 2021 will be in Pittsburgh, USA and
Banff, Canada. Banff 2019 will have a regenerative
medicine/tissue engineering themed pre-meeting.
New Kinnear Conference Center holding 470 people at the Banff Centre for Conferences!

103. From Kinnear Centre Where We Will Be in 2021 Can
See TransCanada Pipeline Pavilion out the Window!
Can see our original site for Banff 1991, 1993, and 1995 out the window!!

104. Kim Solez, MD

105. It Was Always the Intention that Banff Would
be Digital, Portable, Morphometric, AI Based.
Can see our original site for Banff 1991, 1993, and 1995 out the window!!

106. Banff Has Progressed As Far As It Can in the Low
Tech Route. Future Major Advances Will Require
High Tech Approaches: Digital Path /Artificial
Intelligence/Genomics/Regen Medicine.

107. Applications of AI in Medicine

108. AI and Pathology Came Together in April 2017 FDA
Approval of Digital Pathology for Primary Diagnosis

109. In 2018 the First Ever Digital Pathology and AI
Congress in New York City

110. I recruited Digital Pathology expert Yukako Yagi to
joint UAlberta/Univ. Pittsburgh position in early
1990s!
Now at Memorial Sloan Kettering, she was one of keynote speakers at
2018 Digital Pathology and AI Congress.

111. Almost Overnight Pathology Went From Having
the Worst Promotion of Any Specialty to the
Best. We became the Hollywood of Medicine!

112. Gone Are The Blood And Guts. Now Every Page
is Visually Appealing and Seductive!

113. Every Effort Is Made to be Reassuring and
Comforting.
“AI pathology is never going to
replace pathologists.”
“Nobody should feel threatened by
advances in computational pathology.”
“The integrative aspects of pathology,
the cognitive abilities of pathologists,
and the collective wisdom generated
over many years as a community
cannot be replaced by a machine.”

114. These statements are only true near term, not
forever:
“AI will really help enrich your ability to
practice pathology and improve your
ability to serve your patients.”
“AI is not here to remove pathologists
from the decision-making process.”
“(AI is) an exciting step forward in the
discipline of pathology – one that puts
pathologists at the very center of clinical
care and precision
therapeutics.”

115. Pathologists Will Remain Central Only So Long As They
Add Value To The Process. And about being replaced:
Bertalan Mesko - The Medical Futurist
states it correctly:
“AI will not replace physicians, but
physicians using AI will replace
physicians not using AI.”

116. All Five Reasons in this Online 2018 Article are
Unsupported & Incorrect:
Bertalan Mesko - The

117. All Five Reasons in this Online 2018 Article are
Unsupported & Incorrect:
Bertalan Mesko – The Medical Futurist incorrectly
states that:
1. AI cannot be empathetic.
2. AI cannot do nonlinear thinking.
3. Machines cannot interpret data.
“No robot or algorithm could clearly interpret complex, multi-
layered challenges – involving the psyche. While they will
provide the data, interpretation will always remain human
territory.”
https://medicalfuturist.com/5-reasons-artificial-intelligence-wont-replace-physicians
4. There will always be tasks like the Heimlich maneuver algorithms and
robots can never complete.
5. Human machine cooperation is the ultimate solution. There is
nothing better.

118. New Finnish Government AI course
www.elementsofai.com Says We Do Not Need to Fear AI
because Self Improvement Requires Human Help.
“… even if a system could optimize its own workings, it would keep
facing more and more difficult problems that would slow down its
progress, quite like the progress of human scientists requires ever
greater efforts and resources by the whole research community and
indeed the whole society, which the … entity wouldn’t have access
to. … human society still has the power to decide what we use AI
technology for. (With progress in AI we become)…better at controlling any
potential risks due to it.”

119. Machines Will Be Able to Create Their Own Models of
the World but Humans Will Want to Get a Word in
Edgewise!
https://www.theguardian.com/books/2018/jun/15/rise-of-the-machines-has-
technology-evolved-beyond-our-control-

120. Machines Will Be Able to Create Their Own Models of the
World but Humans Will Want to Get a Word in Edgewise!
"Google Translate was known for its humorous errors, but in 2016, the system started using a
neural network developed by Google Brain, and its abilities improved exponentially. Rather
than simply cross-referencing heaps of texts, the network builds its own model of the world,
and the result is not a set of two-dimensional connections between words, but a map of the
entire territory. In this new architecture, words are encoded by their distance from one
another in a mesh of meaning – a mesh only a computer could comprehend."
https://www.theguardian.com/books/2018/jun/15/rise-of-the-machines-has-technology-evolved-beyond-our-
control-
• https://www.theguardian.com/books/2018/jun/15/rise-of-the-machines-has-technology-evolved-beyond-our-
control-

121. Fictional Worlds Presented to Sentient AI As Fact
Threaten Humanity’s Survival
AI Will be Sensitive to Lies About Itself

122. Fictional Worlds As Models of the Real World Exist
Already in 2018 and Will Increase in Number and
Influence

123. YouTube channel www.youtube.com/user/kimsolez
explores pathologist/AI interaction and tissue
engineering pathology influence in the future. Rate
of subscription has increased six fold in 2018!
New Kinnear Conference Center holding 470 people at the Banff Centre for Conferences!