Most Transmitted Glomerular Lesions in a Zero-Hour Biopsy of Allograft Kidney Have No Clinical Significance

Abstract

Background: The clinical significance of glomerular lesions detected in zero-hour renal allograft biopsies have yet to be fully examined.

Methods: We retrospectively reviewed 229 zero-hour renal allograft biopsies, and investigated the prevalence of transmitted glomerular lesions and their association with urinary abnormalities.

Results: Of 117 cases to which immunofluorescence microscopy was applied, immune complex-associated glomerular lesions were found in eight cases (6.8%). Seven cases were diagnosed with immunoglobulin A nephropathy and none accompanied significant urinary abnormalities during the mean follow-up period of 21.9 months. The other case was diagnosed as C1q nephropathy, revealing significant proteinuria and hematuria 1 month after transplantation. The remaining glomerular abnormalities included focal segmental glomerular sclerosis in five cases, focal endocapillary leukocyte infiltration in three cases, and glomerular fibrin thrombi in three cases. Urinary abnormalities were absent during the follow-up period in all of the cases.

Conclusions: Our observations suggest that most of the transmitted glomerular lesions were clinically irrelevant and that a renal biopsy is unnecessary to include in a pre-transplant donor evaluation procedure.