Histopathological features of indicative renal allograft biopsies in pediatric transplant recipients

Objective To analyze the histopathologic features of indicative renal allograft biopsies in pediatric transplant recipients. Methods Histopathologic data of renal allograft biopsies from January 2003 to March 2017 in pediatric transplant recipients were retrospectively analyzed. Results There were 35 pediatric recipients who underwent 43 incidents of allograft biopsies. The most common pathologic findings were acute rejection (11/35, 31.4%) and de novo or recurrent nephropathy (9/35, 25.7%). Acute rejection comprised acute T cell-mediated rejection (8/11, 72.7%) and acute antibody-mediated rejection (3/11, 27.3%). De novo or recurrent allograft nephropathy comprised IgA nephropathy (5/9, 55.6%), focal segmental glomerulosclerosis (2/9, 22.2%) and hemolytic uremic syndrome (1/9, 11.1%). The other pathologic findings included interstitial nephritis (4/35, 11.4%), BK virus associated nephropathy, renal allograft lymphoma, calcineurin inhibitor nephrotoxicity and oxalate nephropathy, etc. Conclusion The main causes of indicative renal allograft biopsies in pediatric recipients are acute rejection and de novo or recurrent allograft nephropathy. Renal allograft biopsy provides instructive values for the diagnosis and precision treatment of post-transplant morbidities. Key words: Kidney transplantation; Child; Kidney biopsy; Acute rejection; Renal allograft nephropathy