title: The prognostic value of frozen section preimplantation graft biopsy in the outcome of renal transplantation.
abstract: BACKGROUND
  Preimplantation biopsy provides a window on the state of the renal allograft. In this study, the prognostic value of frozen section preimplantation graft biopsy was estimated and compared to regularly processed formalin-fixed biopsy.
  
  
  METHODS
  Seventy-four renal allograft recipients were studied. The degree of glomerulosclerosis, acute tubular necrosis, interstitial fibrosis, arteriosclerosis, and arteriolosclerosis was rapidly estimated in frozen sections and correlated to the renal function in the immediate posttransplantation period and 3 months thereafter. The histological changes were also examined in paraffin-embedded sections.
  
  
  RESULTS
  The histological changes observed in rapidly processed frozen sections were comparable to those observed on regularly processed sections and their differences did not reach statistical significance. Glomerulosclerosis and arteriolosclerosis were underestimated, whereas acute tubular necrosis and interstitial fibrosis were overestimated, in the frozen sections compared to permanent ones, but those differences were not statistically significant. Immediate graft function was observed in 45 patients (61%). Delayed graft function was more frequently observed among recipients with donor age above 60 years (57% vs. 32%). Serum creatinine 3 months after transplantation was above 2 mg/dL in 33 recipients (44.5%) and was positively correlated to the degree of tubular necrosis (p = 0.04) and donor age (p = 0.03). Donor age was correlated to the degree of arteriolosclerosis (p < 0.01).
  
  
  CONCLUSIONS
  Frozen section preimplantation biopsy gives reliable information for the situation of the graft that is related to the outcome of renal transplantation.
authors.affiliation: Transplantation Center, University Hospital of Patras, 26500, Patras, Greece. dgoumenos@med.upatras.gr
authors.forename: Dimitrios S
authors.initials: DS
authors.lastname: Goumenos
authors.forename: Pantelitsa
authors.initials: P
authors.lastname: Kalliakmani
authors.forename: Athanassios C
authors.initials: AC
authors.lastname: Tsamandas
authors.forename: Ioannis
authors.initials: I
authors.lastname: Maroulis
authors.forename: Eirini
authors.initials: E
authors.lastname: Savidaki
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Fokaefs
authors.forename: Evangelos
authors.initials: E
authors.lastname: Papachristou
authors.forename: Dionissios
authors.initials: D
authors.lastname: Karavias
authors.forename: John G
authors.initials: JG
authors.lastname: Vlachojannis
mesh_terms: D000328:Adult; D000367:Age Factors; D001707:Biopsy, Needle; D005260:Female; D005629:Frozen Sections; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007674:Kidney Diseases / Q000473:pathology* / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011379:Prognosis; D012307:Risk Factors