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The Need for Better Understanding of Transplant Glomerulitis

We read the article by Batal et al., as well as the accompanying editorial by Gibson, with great interest (1,2). The authors have evaluated glomerulitis, using three different scoring systems in 112 biopsies with tubulointerstitial inflammation and concluded that the current Banff approach is superior to the other two methods studied and showed that biopsies with g3 are more likely to be associated with DSA (40%) and PTC C4d (50%) positivity, persistence of glomerulitis and worse graft survival. We have some concerns regarding the way that this study was designed and the interpretation of the data.