Histopathological diagnoses revealed by indication-based renal allograft biopsies: a retrospective analysis

Authors : Eryigit EREN, Mehmet TOKAC, Alaaddin AYDIN, Taylan ŞAHİN, Hikmet Bora USLU, Selman ALKAN, Ayhan DİNÇKAN

Pages : 1240-1244

Doi:10.18621/eurj.1330877

View : 57 | Download : 54

Publication Date : 2023-09-04

Article Type : Research Paper

Abstract :Objectives: Although there have been several advances in post-solid organ transplantation immunosuppression medications over the last two decades, the long-term survival of renal allografts did not significantly improve. Renal allograft biopsy is a helpful tool for determining the cause of graft dysfunction and adjusting patient management. Methods: Patients who received kidney transplantation and underwent allograft biopsy in Istinye University Hospital between January 2017 and January 2023 constituted the target population of this study. Demographic parameters, clinical data and biopsy indications, and histopathological assessment results of the patients were retrospectively analyzed. Results: Overall, 74 patients were included. The histopathology results included acute T-Cell mediated rejection insert ignore into journalissuearticles values(TCMR); insert ignore into journalissuearticles values(n = 15, 20%);, tubular atrophy/chronic allograft nephropathy insert ignore into journalissuearticles values(IFTA); insert ignore into journalissuearticles values(n = 11, 15%);, calcineurin inhibitor insert ignore into journalissuearticles values(CNI); toxicity insert ignore into journalissuearticles values(n = 2, 3%);, chronic antibody-mediated rejection insert ignore into journalissuearticles values(ABMR); insert ignore into journalissuearticles values(n = 2, 3%);, borderline pathology insert ignore into journalissuearticles values(n = 10, 13.5%);, normal histology insert ignore into journalissuearticles values(n = 5, 6.5%);, transplant glomerulopathy insert ignore into journalissuearticles values(TG); insert ignore into journalissuearticles values(n = 5, 6.5%);, acute ABMR insert ignore into journalissuearticles values(n = 4, 5%);, acute tubular necrosis insert ignore into journalissuearticles values(n = 7, 9%);, polyomavirus nephropathy insert ignore into journalissuearticles values(n = 3, 4%); and non-specific changes insert ignore into journalissuearticles values(n = 10, 13.5%);. The C4d was positive in 12% insert ignore into journalissuearticles values(n = 9); of the graft biopsies. In 73% insert ignore into journalissuearticles values(n = 54); of cases, the treatment strategy was changed based on biopsy results. Among all patients, 19 insert ignore into journalissuearticles values(25.6%); lost their grafts during follow-up. Conclusions: According to the histopathological analysis results, acute TCMR, IFTA, and borderline pathology were the most common causes of renal graft dysfunction. Renal allograft biopsy led to a remarkable change in treatment strategies in a significant number of cases.
Keywords : Renal, allograft, biopsy, histopathology, diagnosis