The role of biopsy in differential diagnostics of kidney graft pathology

Introduction. Different pathological changes of kidney transplants have similar symptoms, thus differential diagnostic is sometime difficult. The important information that may help to set correct diagnose can be obtained from the kidney transplant biopsy followed by pathohistological investigation. Aim of the study. The aim of this study is to demonstrate the role of biopsy in differential diagnostics of kidney graft pathology. Materials and methods. 109 kidney graft biopsies were performed at the Latvian Transplantation Centre in 2007: 20 were protocol biopsies and 89 were performed according to indications (graft dysfunction). All biopsies were performed under USS control followed by pathohistological investigations of the material obtained. Morphological changes were evaluated accordingly to the Banff 97 classification. Results. The morphological findings were as follows: borderline changes - 8 cases (7.34%); acute cellular rejection - 80 cases (73.4%); acute humoral rejection - 1 case (0,92%); hronic graft nephropathy - 27 cases (24.8%); tubolointersticial nephritis - 36 cases (33%); apostematous nephritis - 1 case (0.92%). We observed mild hematuria in only 2 patients after biopsy which stopped spontaneously in a few days. Conclusions. Kidney graft biopsy followed by pathohistological investigation of the material obtained is a precise and sensitive method in the diagnostic process of pathological changes of the graft with a small rate of complication.