ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 39 of 61
УЖМБС 2019, 4(5): 256–261
Clinical Medicine

Pathological Peculiarities of Recipients Kidney Transplant Biopsy depending on the Expression of Disturbance of the Allograft Functional Condition

Yakimenko V. V.

Currently, the best treatment for patients with end-stage chronic renal failure is kidney transplantation. Relapse of terminal renal failure in patients after kidney transplantation exacerbates the problem of the ever-increasing shortage of donor organs. The purpose of the study was to study the histopathological features of renal transplant biopsy specimens in recipients, depending on the severity of allograft dysfunction in patients with preserved depuration function and renal graft dysfunction in the long-term after kidney transplantation. Material and methods. For the period 2014-2016 an ultrasound examination of the kidney transplants were performed in 10 patients with creatinine level within the standard values and in 10 patients with the creatinine level exceeding the standard values. To diagnose the nature of the morphological changes in the renal graft, Banff classification was used. Results and discussion. Evaluation of histological changes in renal transplant biopsy specimens according to the Banff classification showed that recipients with chronic allograft dysfunction in the late postoperative period had more pronounced pathological changes compared with patients with normal allograft function, which were characterized by a more frequent presence of glomerulitis (χ2g1 = 33.47, (p <0.001) and χ2g2=31.16 (p<0.001)), tubulitis (χ2 t2=20.83, p<0.001), intimate arteritis (χ2v1=27.13 (p<0.001) and χ2 v2=15,5 (p<0.001) and interstitial fibrosis (χ2ci0=17.86 (p<0.001) and χ2ci2=27.46 (p<0.001)). Conclusions. The obtained data also reliably indicated the negative micromorphological changes in the renal allograft transplant as renal hemodynamic disturbances increased at the level of the interlobular arteries spectrum (middle segment). It also negatively influences the prognostic role of the TAMX indicator of the aforementioned vessels as inversely correlated with the degree of histological pathological findings according to the Banff classification of allograft biopsies ƮKendall (v-TAMX) -0.69 (p <0.05) and ƮKendall (ci-TAMX) -0.81 (p <0.01) for intimal arteritis and interstitial fibrosis, respectively).

Keywords: kidney biopsy puncture, late allograft dysfunction, pulsation index, doppler sonography

Full text: PDF (Ukr) 212K

  1. Kakuta Y, Okumi M, Unagami K, Iizuka J, Takagi T, Ishida H, Tanabe K. Outcomes, complications, and economic impact of ABO-incompatible living kidney transplantation: A single-center Japanese cohort study. Clin Transplant. 2019 May 11; 33(6): e13591.
  2. Sonnenberg EM, Cohen JB, Hsu JY, Potluri VS, Levine MH, Abt PL, et al. Association of Kidney Transplant Center Volume With 3-Year Clinical Outcomes. Am J Kidney Dis. 2019 May 7; XX:
  3. Tirtayasa PMW, Duarsa GWK, Situmorang GR, Yudiana IW, Santosa KB, Oka AAG, et al. Association between Early Resistive Index Measurement and Early Graft Function and Long-Term Graft Survival after Kidney Transplantation: an Evidence-based Clinical Review. Acta Med Indones. 2019 Jan; 51(1): 77-85.
  4. Zograb’yan RO. Transplantatsiya nyrky vid AV0-nesumisnogo zhyvogo rodynnogo donora [Transplantation of the kidney from AB0-incompatible living relative donor]. Pochki. 2015; 4: 45-9. [Ukrainian]
  5. Fernandez N, Lorenzo A, Chua M, Koyle MA, Farhat W, Matava C. Real-time kidney graft perfusion monitoring using infrared imaging during pediatric kidney transplantation. J Pediatr Urol. 2019 Mar; 15(3): 222.e1-222.e7.
  6. Bejic M, Déglise S, Venetz JP, Nseir G, Dubuis C, Saucy F, Berard X, Meuwly JY, Corpataux JM. Use of Intraoperative Duplex Ultrasound and Resistance Index Reduces Complications in Living Renal Donor Transplantation. Transplant Proc. 2018 Dec; 50(10): 3192-8.
  7. Galgano SJ, Lockhart ME, Fananapazir G, Sanyal R. Optimizing renal transplant Doppler ultrasound. Abdom Radiol (NY). 2018 Oct; 43(10): 2564-73.
  8. Racusen LC, Solez K, Colvin RB, Bonsib SM, Castro MC, Cavallo T, et al. The Banff 97 working classification of renal allo-graft pathology. Kidney Int. 1999; 55: 713-23.