title: Early protocol renal allograft biopsies and graft outcome.
abstract: To evaluate whether biopsies performed early after transplantation in stable grafts can predict graft failure due to chronic transplant nephropathy, a protocol biopsy was performed at three months in 98 patients treated with antilymphocytic antibodies, cyclosporine and prednisone. Patients were followed for 58 +/- 16 months. Histological diagnosis according to the Banff schema were: normal (N = 41), borderline changes (N = 12), chronic transplant nephropathy (CTN; N = 30), CTN associated to borderline changes (N = 11) and acute rejection (N = 4). Biopsies displaying acute rejection were not considered for statistical analysis. Since clinical characteristics of patients displaying CTN either with or without tubulitis were not different, biopsies were grouped as presence or absence of CTN. Patients displaying CTN had an increased incidence of acute rejection before performing biopsy (24.3 vs. 3.9%, P = 0.003), a higher mean cyclosporine level until biopsy (242 +/- 74 vs. 214 +/- 59 ng/ml, P = 0.049) and a lower actuarial graft survival (80.5% vs. 94.4%, P = 0.024). We conclude that early protocol biopsies are useful to detect patients at risk of losing their graft due to chronic transplant nephropathy.
authors.affiliation: Department of Nephrology, Ciutat Sanitària i Universitària de Bellvitge, Barcelona, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Serón
authors.forename: F
authors.initials: F
authors.lastname: Moreso
authors.forename: J
authors.initials: J
authors.lastname: Bover
authors.forename: E
authors.initials: E
authors.lastname: Condom
authors.forename: S
authors.initials: S
authors.lastname: Gil-Vernet
authors.forename: C
authors.initials: C
authors.lastname: Cañas
authors.forename: X
authors.initials: X
authors.lastname: Fulladosa
authors.forename: J
authors.initials: J
authors.lastname: Torras
authors.forename: M
authors.initials: M
authors.lastname: Carrera
authors.forename: J M
authors.initials: JM
authors.lastname: Grinyó
authors.forename: J
authors.initials: J
authors.lastname: Alsina
mesh_terms: D000328:Adult; D001706:Biopsy; D002102:Cadaver; D003404:Creatinine / Q000097:blood; D005069:Evaluation Studies as Topic; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D011237:Predictive Value of Tests; D014184:Transplantation, Homologous
chemical_list: D003404:Creatinine