Clinical Significance of Protocol Allograft Renal Biopsy in a Tertiary Care Centre in India

Background: The assessment of biopsy findings at one month post-kidney transplant is crucial in determining the success of the procedure and identifying potential complications.

Aim: This study aimed to investigate the association between biopsy findings at one month and donor status, as well as HLA DR (Human Leukocyte Antigen – DR isotype) mismatch, in kidney transplant recipients.

Methods: A total of 30 kidney transplant recipients were included in the study. Biopsy findings at one month were categorized as either normal or indicative of rejection. The association between biopsy findings and donor status (cadaveric vs. live donor) and HLA DR mismatch (present vs. absent) was analyzed using the Fisher exact test.

Results: Among patients who received a cadaveric donor kidney, all four (100%) exhibited normal biopsy findings at one month, with no cases of rejection observed. In contrast, among recipients of a live donor kidney, 23 (88.5%) had normal biopsy findings, while 3 (11.5%) showed signs of rejection. Regarding HLA DR Mismatch, among patients without HLA DR mismatch, 26 (96.3%) had normal biopsy findings at one month, with only 1 case (3.7%) showing rejection. Conversely, among patients with HLA DR mismatch, only 1 (33.3%) had normal biopsy findings, while 2 cases (66.7%) exhibited rejection.

Conclusion: Our findings suggest that HLA DR mismatch may be associated with an increased risk of biopsy findings indicative of rejection at one month post-kidney transplant. However, no significant association was observed between donor status and biopsy findings.