Repeat True Surveillance Biopsies in Kidney Transplantation

Abstract

Less than 50% of protocol biopsies were performed in the absence of any clinical signs of graft dysfunction. A high proportion of these biopsies revealed pathological findings that were associated with a significant decrease in long-term graft function.

Impact of donor ABH‐secretor status in ABO‐mismatched living donor kidney transplantation

“…Protocol biopsies were taken after 1 week and after 3, 6, and 12 months. In general, two needle biopsy cores were obtained for morphologic workup and processed as previously described . Core biopsy needles of 16‐gauge were used, thus reducing the risk of sampling error.…”

“…In general, two needle biopsy cores were obtained for morphologic workup and processed as previously described. 15,16 Core biopsy needles of 16-gauge were used, thus reducing the risk of sampling error. Immunofluorescence for detecting deposition of immunoglobulins and complement factors as well as expression of ABO blood group antigens was performed for each biopsy.…”

The value of long‐term protocol biopsies after kidney transplantation

“…Early detection and treatment of subclinical rejection improves outcome. However, reported incidence rates of subclinical rejection differ widely, varying from 1% to 45% in the first 3–6 months post transplantation . Some reasons for the differences in reported subclinical rejection rates include variation in human leukocyte antigen (HLA) matching, the incidence of delayed graft function, and the immunosuppressive protocol used .…”

“…However, reported incidence rates of subclinical rejection differ widely, varying from 1% to 45% in the first 3-6 months post transplantation. 1,2,[14][15][16] Some reasons for the differences in reported subclinical rejection rates include variation in human leukocyte antigen (HLA) matching, the incidence of delayed graft function, and the immunosuppressive protocol used. 2 Also, the difference can be explained in part by the inclusion of borderline changes, use of different inclusion criteria, and different timings of the biopsies.…”

“…Current literature mainly discusses the significance of subclinical rejection during the early post‐transplant period. It has been suggested that protocol biopsies performed within the first year after kidney transplantation for the detection and treatment of subclinical rejection may be a major factor in preserving long‐term graft function . However, the benefit of long‐term allograft biopsies is largely unproved, and the strategy is yet to be widely implemented.…”