Clinicopathological Results of Percutaneous Transplant Kidney Biopsies: Single Center Nine Years' Experience

Abstract

Background: Based on clinical criteria alone, the cause of graft dysfunction cannot be accurately predicted in 40-70% of cases. Therefore, renal allograft biopsy is still the gold standard for accurate diagnosis. We performed this study to evaluate the causes of renal graft dysfunction detected in renal allograft biopsies in our center. Methods: The results of 90 patients who underwent renal allograft biopsy between May 2013 and June 2022 from kidney transplant patients were evaluated retrospectively. Results: It was determined that 92 biopsies were performed from 90 patients and all were ‘cause’’ biopsies. The mean age was 40.03±14.29 years. 82 of the kidney transplants were from living donors. 21 patients had preemptive transplantation. The type of renal replacement therapy before transplantation was hemodialysis in 52 patients, PD in 3 patients, PD and HD in 3 patients. The reason for biopsy was high creatinine in 67 patients, proteinuria in 23 patients, and BKV viremia in 2 patients. The mean discharge creatinine value was 1.64±1.11mg/dl, and the mean creatinine before biopsy was 3.06±2.07mg/dl. Although there was kidney tissue in one of the allograft biopsies, there was no glomeruli. The mean number of cores taken was 2.94±0.61, and the number of glomeruli was 21.33±11.64. In one of the 92 biopsies performed, bleeding requiring transfusion developed. No other biopsy-related complications were observed. Graft loss was observed in 46 of 90 patients during the follow-up period. Conclusions: Evaluation of serum creatinine and urinalysis may be useful in predicting histological graft diagnosis, but an allograft biopsy is necessary for definitive diagnosis.