Background: In simultaneous pancreas and kidney transplant (SPKTx) recipients, animal studies suggest concordant rejection rates of 88% (ref: Gruessner et al,1994). Limited information is available describing histologic concordance rejection rates of pancreas and kidney among human SPKTx recipients receiving biopsy of both organs at the same time (i.e. concomitant biopsies).

Aim: Determine the incidence and grade of rejection of pancreas and/or kidney in a cohort of SPKTx patients undergoing concomitant biopsies.

Methods: Retrospective chart review of all SPKTx recipients between 2003 and 2015 who had at least 1 concomitant biopsy including protocol and for-cause biopsies. All biopsies were graded using Banff criteria.

Results:

Study cohort:104 SPKTx patients had at least 1 concomitant biopsy. For this analysis we excluded all biopsies deemed indeterminate for rejection.

The total number of concomitant biopsy pairs was 198. The concomitant rejection rate (i.e. rejection of both the kidney and pancreas) was low at 4.5% (n=9).

Among the remaining 189 pairs (198-9=189), rejection of pancreas alone was 27.5% (n=52), and kidney alone was 4.8% (n=9).

Comparison of Rejection Grades

ACR=acute cellular rejection; AMR=antibody-mediated rejection

Conclusion: Concomitant biopsies of both kidney and pancreas reveal low histologic concordance of rejection. Thus, one cannot assume a negative biopsy in one organ indicates absence of rejection in the other organ.

CITATION INFORMATION: Johnson C, Johnson K, Kaplan B, Temkit M, Heilman R, Sukumaran Nair S, Khamash H, Huskey J, Mour G, Chakkera H. Utility of Concomitant Biopsy in Simultaneous Pancreas Kidney Transplant Recipients in the Identification of Rejection of Pancreas and Kidney. Am J Transplant. 2017;17 (suppl 3).

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