Indication for Biopsy: Renal Allograft

Abstract

Most renal allograft biopsies are done because of impaired excretory function, called graft dysfunction. The two common problems for a pathologist are to decide whether there is significantly active, acute rejection, that may respond to treatment, and whether there is chronic damage, that will not respond to treatment. There are five diagnoses related to acute rejection. These are antibody mediated rejection, significant acute cellular rejection, acute vascular rejection, severe acute vascular rejection, and no evidence of significant acute rejection. Late damage in an allograft, meaning tubular atrophy in particular, may result from chronic rejection, but there are several other possible explanations. Other disorders that may occur in grafts include glomerular abnormalities that may be due to a variety of causes, vascular and ureteric problems, infections, and neoplasms.