Baseline Biopsy in Kidney Transplantation

Abstract

While baseline biopsy at renal transplantation is useful and performed routinely, the difference of pathology samples before and after allograft recirculation have not been reported. We analyzed both samples (0 and 1 hour biopsy) retrospectively and the outcome of clinical course. Firstly we compared the pathological diagnosis with Banff score for each biopsies, secondly we examined whether 1 hour biopsies could predict the postoperative clinical course. Clinical record of consecutive 43 renal transplantation was reviewed from 2009 to 2012. The pathological diagnosis included 22 no major abnormalities, 15 acute tubular injury, 1 acute tubular necrosis, 3 mesangial IgA deposition and 2 diabetic change. Diagnosis of 0 hr biopsies was exactly same as that of 1 hr, and difference of Banff score in both biopsies was within 1 grade points. Although clinical acute antibody-mediated rejection was detected in 3 cases in early days after kidney transplantation, their 1 hr biopsy revealed no major abnormalities. Mild C4d deposition on peritubular capillaries of 1 hour biopsy specimen did not affect postoperative clinical course. There was no significant pathological difference between 0 hr and 1 hr biopsies. We could not clarify clinical necessity for both biopsies for each patient.