The Banff working group for allograft pathology represents the international consensus platform for generating and refining diagnostic standards in the area of organ transplantation. Every 2 years a Banff meeting is held and participants review recent data in the field, aiming to adjust the classification systems to current knowledge. The 10th Banff Conference on Allograft Pathology was held in Banff, Canada from August 9 to 14, 2009. A total of 263 transplant clinicians, pathologists, surgeons, immunologists, and researchers discussed several aspects of solid organ transplants with a special focus on antibody-mediated graft injury. The willingness of the Banff process to adapt continuously in response to new research and improve potential weaknesses in a data-driven, evidence-based way led to the implementation of six working groups in the following areas: isolated v-lesion, fibrosis scoring, glomerular lesions, molecular pathology, polyomavirus nephropathy, and quality assurance. Banff working groups will conduct multicenter trials to evaluate the clinical relevance, practical feasibility, and reproducibility of potential changes to the Banff classification. In addition, compelling molecular research data led to the discussion of combining histopathology and molecular parameters within the Banff working classification in the near-future. © 2010 Springer-Verlag.