Background

Much debate exists over the utility of protocol biopsies for pediatric kidney transplant recipients. While there is a growing amount of literature on the utility of protocol biopsies in adult kidney transplant recipients, less literature exists in regards to pediatric recipients. Protocol biopsies could potentially allow the early diagnosis and treatment of subclinical acute and chronic renal allograft injury.

Objective

To assess the usefulness of protocol biopsies in pediatric kidney transplant patients.

Design/Methods

A retrospective chart review was conducted of children receiving a kidney transplant between July of 2012 to November of 2015 who had a protocol biopsy at 6 months, 12 months, and/or 2 years post-transplant. Inclusion required recipients to have at least received one protocol biopsy and be under the age of 18 at the time of transplant. Data was collected using medical records. All for cause biopsies were excluded.

Results

There were a total of 14 pediatric kidney transplant recipients with 29 protocol biopsies eligible for review. Of the 14 recipients, 12 received 6-month protocol biopsies, 10 received 1-yr protocol biopsies, and 7 received 2-yr protocol biopsies

. All patients at time of biopsy had their baseline serum creatinine. All borderline ACRs had their immunosuppression increased. The 1A ACR received a steroids pulse and the AMRs received velcade, pheresis, IVIG and Rituximab.

Conclusions

These results suggest that protocol biopsies are valuable to the management of pediatric patients post-transplant in that they detect subclinical acute and chronic injury to the renal allograft, which subsequently alters management which could potentially increase graft survival.

CITATION INFORMATION: Nazario M, Moussa O, Self S, Twombley K. Benefit of Protocol Biopsies in Pediatric Kidney Transplant Patients. Am J Transplant. 2016;16 (suppl 3).

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