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Nephrol Dial Transplant (2003) 18: 644-647
© 2003 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Protocol biopsy: what is the rationale and what is the evidence?

Christian Morath, Eberhard Ritz and Martin Zeier

Department of Nephrology, University of Heidelberg, Heidelberg, Germany

Keywords: acute rejection; allograft nephropathy; cyclosporin A toxicity; delayed graft function; protocol biopsy; stable renal graft

The first 150 words of the full text of this article appear below.

Introduction

The incidence of acute rejection (and the proportion of grafts lost during the first year after renal transplantation) have markedly decreased after the introduction of cyclosporin A. The reduction of the rate of graft loss after the first year, however, has been much less impressive. Chronic transplant nephropathy has become the most common cause of late graft failure [1]. Chronic allograft nephropathy is strongly correlated with the number of acute rejection episodes during the first year after renal transplantation [2,3]. In the past, the possibility of graft failure was suspected only when a sustained and irreversible decline of renal function was evident, usually in the context of proteinuria and hypertension. Unfortunately, by the time the clinical diagnosis was confirmed by histology renal scarring was usually too advanced to make delayed treatment a promising proposition.

Traditionally, renal allograft biopsies were performed mainly in the setting . . . [Full Text of this Article]

Subclinical acute rejection in patients with a stable renal graft

What are the consequences of a biopsy-proven rejection without impairment of renal function?

Acute rejection in patients with delayed graft function

Chronic allograft nephropathy in patients with stable graft function

Non-immunological causes of graft failure

Conclusion


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A. Wilkinson
Protocol Transplant Biopsies: Are They Really Needed?
Clin. J. Am. Soc. Nephrol., January 1, 2006; 1(1): 130 - 137.
[Abstract] [Full Text] [PDF]