Frequency of Histological Patterns of Renal Allograft Biopsies– One Year of Renal Allograft Experience

Abstract

Objective: To ascertain the frequency and spectrum of histopathological findings in renal allograft rejection cases received in one year.

Study Design: Cross-sectional study.

Place and Duration of Study: Histopathology Department of Armed Forces Institute of Pathology, Rawalpindi Pakistan from Jun 2020 to May 2021.

Methodology: Renal allograft rejection biopsy cases of 62 male and female patients between the ages of 15-60 years having undergone renal transplant with prior end-stage renal disease over one year were collected. Frequency and histopathological findings were studied after classifying them according to the Banff Classification.

Results: Cellular (T-cell mediated) rejection accounted for more than half of the cases under study, making it the most common cause of transplant rejection in our demographical area. It accounted for 28 (45.2%) slides of all the biopsies studied. Antibody-mediated rejection followed next with 17 (27.4%) slides, with seven slides (11.3%) of the cases borderline for changes accounting for a T-Cell mediated rejection. About 10 (16.2%) were non-specific changes negative for transplant rejection criteria.

Conclusion: Our study was instrumental in establishing rejection patterns and major rejection sub-types while classified under the Banff Classification in our demographical area. The cataloguing of the cases and the major underlying cause would help minimize rejection rates resulting in better clinical outcomes and increased patient survival.