Abstract
Introduction: Following renal transplant, renal dysfunction is not uncommon. Assessment of histopathological changes in renal dysfunction is done using the Banff ’07 Update to the Banff 97 Diagnostic Categories for Renal Allograft Biopsies which is the accepted formulation worldwide.
Objectives: To evaluate the spectrum of histopathological changes seen in renal allograft dysfunction.
Materials and Methods: A retrospective study was conducted in a tertiary care center in South India to analyze all the renal allograft biopsies received by the Department of Pathology, Madras Medical Mission, Chennai, from multiple tertiary centers across India, over a period of 9 years. A total of 1151 renal allograft biopsies from 1120 patients were studied. The biopsies were grouped into six categories according to the Banff 07 update to the Banff 97 diagnostic categories for renal allograft biopsies. Univariate analysis was done and the continuous variables were expressed as percentages.
Results: The study population was predominantly males (75%) with mean age of 37±12.47 years. The median serum creatinine was 2.3 mg/dL. The time of allograft biopsy ranged from 0 hours to 5 years. The maximum number of biopsies obtained for each recipient was three (range 1 to 3). The biopsies were broadly categorized using the Banff criteria (2007 update) into normal (4.95%), antibody-mediated rejection (7.38%), borderline rejection (5.29%), T-cell mediated rejection (31.36%), interstitial fibrosis and tubular atrophy (5.03%) and non-rejection category (41.96%). 46 (3.99%) biopsies were insufficient for categorization.
Conclusion: The appropriate histopathological diagnosis for allograft biopsies aids in tailoring the immunosuppression therapy, prognosticating and appropriate management.