title: Renal graft biopsy assists diagnosis and treatment of renal allograft dysfunction after kidney transplantation: a report of 106 cases.
abstract: Acute antibody mediated rejection (AMR) is one of the most important complications after kidney transplantation. Renal graft biopsy is safe and reliable without adverse effects on the patients and transplanted kidneys, which was of great instructive significance in diagnosis and treatment of renal allograft dysfunction after renal transplantation. This paper reported a case series of 106 patients underwent renal allograft biopsies. All biopsies were evaluated according to the Banff 2007 schema. 52 examples were obtained within 1 month after transplantation, and there were another 20 examples in one to two months and other 34 examples in two to three months. Appropriate therapy was applied and clinical outcomes were observed. All patients received renal biopsies and anti-inflammatory and hemostasis treatment without complications. There were 2 cases of hyperacute rejection, and 15 cases of acute AMR. All Paraffin-embedded samples were stained by HE, periodic acid-Schiff (PAS), Masson, and immunohistochemistry (C4d, cd20, cd45RO, SV40). All samples were found C4d immunohistochemical staining positive. Patients with acute AMR were managed by steroid intravenous pulse therapy, Rabbit anti-thymocyte globulin intravenous pulse therapy, anti CD20 monoclonal antibody intravenous therapy and so on. Two cases of hyperacute rejection had renal failure, and received kidney excision; 12 cases in 15 cases of AMR recovered, another 2 cases did not recover with high-level creatine, and other 2 cases of renal allograft received excision.
authors.affiliation: Institute of Organ Transplantation, The 309th Hospital of Chinese People's Liberation Army Beijing 100091, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Han
authors.affiliation: Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430030, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Guo
authors.affiliation: Institute of Organ Transplantation, The 309th Hospital of Chinese People's Liberation Army Beijing 100091, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Cai
authors.affiliation: Institute of Organ Transplantation, The 309th Hospital of Chinese People's Liberation Army Beijing 100091, China.
authors.forename: Li
authors.initials: L
authors.lastname: Xiao
authors.affiliation: Institute of Organ Transplantation, The 309th Hospital of Chinese People's Liberation Army Beijing 100091, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Institute of Organ Transplantation, The 309th Hospital of Chinese People's Liberation Army Beijing 100091, China.
authors.forename: Xiaoguang
authors.initials: X
authors.lastname: Xu
authors.affiliation: Institute of Organ Transplantation, The 309th Hospital of Chinese People's Liberation Army Beijing 100091, China.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Huang
authors.affiliation: Institute of Organ Transplantation, The 309th Hospital of Chinese People's Liberation Army Beijing 100091, China.
authors.forename: Bingyi
authors.initials: B
authors.lastname: Shi
keywords: Kidney transplantation; perioperative period; renal biopsy; renal insufficiency