Zero-time biopsy provide important information about the organ quality; however its role as acute or chronic renal function predictor is not established. Materials and Methods: We analyzed data from 142 zero-time biopsies in deceased transplant patients realized form 11/2008 to 5/2012. Patients had a follow up of at least 6 months. We analyzed presence of ATN, arteriolar hyalinosis (AH), intimal thickness (IT), interstitial fibrosis (IF) and glomerulosclerosis (GS). We also analyzed the impact of donor features with the following outcomes: delayed graft function (DGF), renal function measured by CrCl at hospital discharge, 6 and 12 months and chronic allograft dysfunction (CAD) defined as CrCl < 60ml/min. Results: We studied 142 patients with a mean follow up of 362 days. The age of donors were 44 years, 29% were extended criteria donors (ECD), 26% had hypertension and 53,3% had cerebral vascular accident as the cause of death. ATN was present in 76% of these bxs, AH in 21,4%, IF in 18,1% and GS in 24,3%. DGF occurred in 78% of our patients. No histological finding at zero-time biopsies was associated to DGF. ClCr at discharge and at 6 mo had no association with histological findings. Patients with AH had a lower CrCl at 12mo, compared to patients without it (37ml/min x 61ml/min, p< 0,003). In a multivariate analysis, donor variables associated with CAD at one year were donor age, OR: 1,11 IC 95%: 1,03-1,20, p=0,005 and intimal thickness, OR: 8,26 IC 9550%: 1,13-60,08, p=0,037. In addition, ECD had significantly more AH and IT (p=0,011 and 0,001, respectively).Conclusion: Vascular abnormalities (AH and IT) and donor age were features associated with a one year poorer renal function. Zero-time bxs can be useful to choose immunosuppression in order to improve long term graft function.

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