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An Analysis of Early Renal Transplant Protocol Biopsies - the High Incidence of Subclinical Tubulitis

Shapiro, R and Randhawa, P and Jordan, ML and Scantlebury, VP and Vivas, C and Jain, A and Corry, RJ and McCauley, J and Johnston, J and Donaldson, J and Gray, EA and Dvorchik, I and Hakala, TR and Fung, JJ and Starzl, TE (2001) An Analysis of Early Renal Transplant Protocol Biopsies - the High Incidence of Subclinical Tubulitis. American Journal of Transplantation, 1 (1). 47 - 50. ISSN 1600-6135

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Abstract

To investigate the possibility that we have been underestimating the true incidence of acute rejection, we began to perform protocol biopsies after kidney transplantation. This analysis looks at the one-week biopsies. Between March 1 and October 1, 1999, 100 adult patients undergoing cadaveric kidney or kidney/pancreas transplantation, or living donor kidney transplantation, underwent 277 biopsies. We focused on the subset of biopsies in patients without delayed graft function (DGF) and with stable or improving renal function, who underwent a biopsy 8.2 ± 2.6 d (range 3-18 d) after transplantation (n = 28). Six (21%) patients with no DGF and with stable or Improving renal function had borderline histopathology, and 7 (25%) had acute tubulitis on the one-week biopsy. Of the 277 kidney biopsies, there was one (0.4%) serious hemorrhagic complication, in a patient receiving low molecular weight heparin; she ultimately recovered and has normal renal function. Her biopsy showed Banff 1B tubulitis. In patients with stable or improving renal allograft function early after transplantation, subclinical tubulitis may be present in a substantial number of patients. This suggests that the true incidence of rejection may be higher than is clinically appreciated.

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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Shapiro, R
Randhawa, P
Jordan, ML
Scantlebury, VP
Vivas, C
Jain, A
Corry, RJ
McCauley, J
Johnston, J
Donaldson, J
Gray, EA
Dvorchik, I
Hakala, TR
Fung, JJ
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 May 2001
Date Type: Publication
Journal or Publication Title: American Journal of Transplantation
Volume: 1
Number: 1
Page Range: 47 - 50
DOI or Unique Handle: 10.1034/j.1600-6143.2001.010109.x
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 1600-6135
Other ID: uls-drl:31735062120864, Starzl CV No. 2178
Date Deposited: 08 Apr 2010 17:37
Last Modified: 02 Feb 2019 13:58
URI: http://d-scholarship.pitt.edu/id/eprint/5564

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