Korean J Transplant.  2022 Nov;36(Supple 1):S319. 10.4285/ATW2022.F-4570.

Histopathological findings of indication kidney allograft biopsy: 16-year experience from a tertiary care center in Korea

• Paek JH
• Kwon J
• Lee HJ
• Kim Y
• Park WY
• Jin K
• Sin H
• Choe M
• Han S

• KMID: 2535546
• DOI: http://doi.org/10.4285/ATW2022.F-4570

Abstract

Background
Kidney allograft dysfunction (KAD) has various causes and presentations. Although many studies on biomarkers for detection of KAD were performed, kidney biopsy remains the gold standard for the diagnosis of KAD. We evaluated the spectrum of histopathological changes seen in KAD.
Methods
We retrospectively reviewed histopathological findings of 490 patients who received kidney allograft biopsy between 2005 and 2021. Among 490 patients, 61 patients who underwent protocol biopsy were excluded.
Results
The mean age at allograft biopsy was 47.9±12.3 years and 289 patients (66.7%) were male. Two hundred thirty-two patients (54.1%) underwent living donor kidney transplantation and mean duration of kidney biopsy was 62.3±70.1 months. The most common cause for allograft biopsy was allograft dysfunction (83.0%), followed by delayed graft function (9.8%) and pro-teinuria (7.2%). Of the 429 patients, the most common pathological finding was chronic antibody-mediated rejection in 17.0%, followed by 66 acute T cell medicated rejection (15.3%), 59 acute antibody-mediated rejection (13.7%), and 31 calcineurin inhib-itor toxicity (7.2%). Incidence of glomerulonephritis was 17.5%. The most prevalent glomerular diseases were immunoglobulin A nephropathy (48.0%), focal segmental glomerulosclerosis (32.0%), and diabetic nephropathy (9.3%).
Conclusions
Clinical presentations do not reliably distinguish the various causes of KAD. Kidney allograft biopsy is a useful tool in the evaluation of allograft dysfunction.