For a study, researchers sought to determine whether the histological features in a transplanted kidney biopsy can predict the graft’s and patient’s prognosis. The other goal was to learn more about the effect of time on biopsy findings.

Between 1 January 2007 and 30 September 2017, data from 1,462 patients were pooled from a kidney transplantation registry and a biopsy registry. Kaplan-Meier and multivariate Cox regression analyses were carried out, and hazard ratios (HR) with 95% CI were provided.

Graft survival after biopsy (gsaBiopsy) was lower in patients with glomerular diseases (HR 8.2, CI:3.2-21.1), rejections (HR 4.2, CI:1.7-10.3), chronic changes including IFTA (HR 3.2, CI:1.3-8.0), acute tubular injuries (HR 3.0, CI:1.2-7.8), and borderline changes (HR 2.9, CI:1.1-7.6) compared to normal biopsy findings. Shorter gsaBiopsy for chronic TCMR (HR 4.7, CI:1.9-11.3), active ABMR (HR 3.6, CI:1.7-7.7), and chronic ABMR (HR 3.5, CI:2.0-6.0) was found in a sub-analysis of rejections. When compared to all other types of rejections, patients with TCMR Banff grade II (HR 0.35, CI:0.20-0.63) and grade I (HR 0.52, CI:0.29-0.93) had a superior gsaBiopsy.

GSA was reduced in kidneys with glomerular disorders, rejections, acute tubular injuries, and borderline alterations. Grade I and II TCMR Banff rejections were connected with a better outcome.