title: Can pre-implantation biopsies predict renal allograft function in pediatric renal transplant recipients?
abstract: OBJECTIVE
  To determine the utility of pre-implantation renal biopsy (PIB) to predict renal allograft outcomes.
  
  
  METHODS
  This is a retrospective review of all patients that underwent PIB from January 2003 to December 2011 at the Great Ormond Street Hospital for Children in London, United Kingdom. Thirty-two male patients (56%) aged 1.5-16 years (median: 10.2) at the time of transplantation were included in the study and followed-up for 33 (6-78) months. The results were compared with 33 controls.
  
  
  RESULTS
  The PIB showed normal histopathological findings in 13 patients (41%), mild chronic vascular changes in 8 (25%), focal tubular atrophy in one, moderate to severe chronic vascular change in 3, mild to moderate acute tubular damage in 6, and tissue was inadequate in one subject. Delayed graft function (DGF) was observed in 3 patients; 2 with vascular changes in PIB, and one with normal histopathological findings. Two subjects with PIB changes lost their grafts. The estimated glomerular filtration rate at 3-, and 6-months post-transplantation was lower in children with abnormal PIB changes compared with those with normal PIB. There was one case of DGF in the control group, and 4 children lost their grafts including the one with DGF.
  
  
  CONCLUSIONS
  Pre-implantation renal biopsy can provide important baseline information of the graft with implications on subsequent medical treatment for pediatric renal transplant recipients.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. E-mail. jkari@doctors.org.uk.
authors.forename: Jameela A
authors.initials: JA
authors.lastname: Kari
authors.forename: Alison L
authors.initials: AL
authors.lastname: Ma
authors.forename: Stephanie
authors.initials: S
authors.lastname: Dufek
authors.forename: Ismail
authors.initials: I
authors.lastname: Mohamed
authors.forename: Nizam
authors.initials: N
authors.lastname: Mamode
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Sebire
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Marks
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D016030:Kidney Transplantation; D008297:Male; D012189:Retrospective Studies; D014184:Transplantation, Homologous