Investigation of Predictive Factors for Function of Transplanted Kidney Graft Based on Zero-Time Biopsy Findings

Kidney transplantation is the most definitive treatment for end-stage kidney failure. The purpose of this research is to investigate the impact of zero-time histopathological findings on kidney graft function and survival and the opportunity of performing interferences, based on it, in the immunosuppression regime of transplant patients. Patients who underwent kidney transplantation from a deceased donor between 2018 and 2021 in Shariati Hospital were studied. They underwent wedge biopsy of the kidney graft just after reestablishing vascular perfusion, and the samples were subjected to histopathology examination according to the Banff scoring system. Afterward, the patients underwent 1-month, 3-month, and 6-month follow-ups with the serum creatinine levels and estimated glomerular filtration rate. The main findings in the histopathological examination of the biopsies were acute tubular necrosis (62%), mesangial proliferation (2.5%), glomerular thrombosis (7.2%), arteriolar hyalinosis (7.2%), interstitial fibrosis and inflammation (23%).  The score of most of the findings was mild and, C4D was also negative in all patients. Seven patients were affected by the delayed graft function (DGF) and among them, glomerulosclerosis was observed in 57%, arterial intimal fibrosis in 7.1%, and interstitial fibrosis in 8.4%. In the 6-month follow-up, the trend of creatinine and GFR of these patients was not as good as the other patients. Although they were not statistically significant. Statistically, no significant relationship was found between the zero-time biopsy findings and the graft performance in the short and medium term. Although this is not sufficient for the conclusion due to the small volume of samples.