Clinical significance of protocol biopsy at one month posttransplantation in deceased-donor renal transplantation

Abstract

Background Protocol biopsy was used to detect pathologic changes in recipients with stable allograft function. With our 5-year practice, we reviewed protocol biopsies performed at 1 month posttransplantation in Chinese renal transplantation to analyze the impact of pathologic changes on allograft survival and to evaluate the clinical significance of protocol biopsy. Methods 227 patients who received biopsy at 1 month posttransplantation during Aug 2000 to Feb 2005 with stable graft function were enrolled. Patients were divided into normal group (NM), borderline change group (BL) and subclinical rejection group (SCR) based on pathology in protocol biopsy. Their clinical data were all reviewed. Results In the 227 patients with stable graft function, there were 173 patients (76.2%), 37 patients (16.3%) and 17 patients (7.5%) in the NM, BL, SCR group respectively. The incidence of acute rejection in the following period was significantly higher in the BL and SCR groups than that in the NM group (21.6%, 29.4% vs 7.5%, P < 0.01). There was a significant difference of graft survival between the BL, SCR group and NM group ( P < 0.01). Conclusions Borderline changes and subclinical rejection detected in protocol biopsy were associated with poor allograft survival. Protocol biopsy performed at 1 month posttransplantation is of great significance and can predict graft survival.