Ditscherlein G, Schneider W, Guddat F, Höppchen R
Z Urol Nephrol. 1986 Nov;79(11):685-90.
During a period of about 4 3/4 years 200 biopsy specimens (= 100%) with judgeable tissue of kidney grafts were examined; from these 99 had been performed during the first 6 months. The best assessment concerned the interstitial cellular rejection which was observed in 73.5%, furthermore, in 9.5% cellular infiltrates of uncertain pathogenesis were found. In 19.5% acute subacute and in 35% chronic transplant vasculopathy occurred while other vascular lesions were relatively rare. Transplantat glomerulopathy was diagnosed in 25% and glomerulonephritis in 14.5%--mostly de novo. In further 26% different minor glomerular abnormalities and in 14.5% chronic ischaemic glomeruli (mostly focally) were observed. The assessment was limited in those cases with lack of arteries (15.5%) or glomeruli (8.5%) within the specimen. However, by judging tubular atrophy and interstitial fibrosis certain conclusions on chronic stenosing arterial processes may be drawn. In the early stage usually the condition of the parenchyma can be assessed well which allows some recommendation for further treatment (conservative therapy or ectomy). On the whole renal biopsy is the best method to assess the state of the transplant.
