The role of protocol biopsies after pediatric kidney transplantation

Data on protocol biopsies (PBs) after pediatric kidney transplantation are rare. We evaluated 6-month post-transplantation renal function in 86 children after PB as observational study. Patients were divided into 3 groups: 1.PB pathological findings absent, no intervention (n = 44);2.pathological findings but stable serum creatinine so no intervention (n = 27);3.pathological findings (borderline rejection (borderline) Banff classification (Banff) Ia or IIa), increased serum creatinine 20%, therapy initiated (n = 15). Glomerular filtration rate (GFR) and delta GFR were determined. 1.Group 1: Mean GFR was 79 mL/min/1.73 m2 body surface area (BSA) (± 23) at time of biopsy. Six months after PB GFR was 75 mL/min/1.73m2 BSA (± 24), delta GFR –4.7 and remained stable until 24 months when it decreased to 64 mL/min/1.73m2 BSA (± 23), delta GFR –15.3.2.Group 2: Mean GFR was 83 mL/min /1.73m2 BSA (± 26). 12 months after PB mean GFR decreased slightly (79 mL/min/1.73m2 BSA (± 29), delta GFR –5.1) and by 24 months had decreased to 75 mL/min/1.73 m2 BSA (± 27), delta GFR –9.6 (1 vs 2 P = .54).3.Group 3: Mean GFR was lower, 59 mL/min/1.73m2BSA (± 23). Six and 12 months after PB mean GFR increased, but by 24 months it had decreased to 51 mL/min/1.73m2 BSA (± 12), delta GFR +2.2 (1 vs 3 P = 0.009, 2 vs 3 P = .035). PBs 6 months post-kidney transplantation did not influence the clinical course in stable pediatric patients and are...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research