Protocol Biopsies in Renal Transplantation: Insights into Patient Management and Pathogenesis

• Published in: American journal of transplantation Vol. 7; no. 3; pp. 512 - 517
• Main Authors: Mengel, M., Chapman, J. R., Cosio, F. G., Cavaillé‐Coll, M. W., Haller, H., Halloran, P. F., Kirk, A. D., Mihatsch, M. J., Nankivell, B. J., Racusen, L. C., Roberts, I. S., Rush, D. N., Schwarz, A., Serón, D., Stegall, M. D., Colvin, R. B.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-03-2007
• Subjects: Biomarkers - analysis; Biopsy; Biopsy - methods; Clinical Trials as Topic; Graft Rejection - diagnosis; Graft Rejection - etiology; Graft Rejection - pathology; Humans; kidney; Kidney Transplantation; Patient Care - methods; Postoperative Complications - diagnosis; Postoperative Complications - etiology; Postoperative Complications - pathology; protocol; rejection; subclinical; surrogate
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/j.1600-6143.2006.01677.x

A 1‐day symposium on the application of protocol biopsies in renal transplantation was held in Boston, 21 July 2006. Representatives from centers with extensive experience in the use of protocol biopsies for routine patient care and research reported results on the pathological findings and their value in patient management. The consensus was that protocol biopsies, in experienced hands, are a safe and valuable means of detecting subclinical disease that can benefit from modification of therapy. Furthermore, molecular studies reveal evidence of activity or progression not readily appreciated by histological techniques. Wider application is expected in multicenter clinical trials to predict and validate outcomes. The principal barrier to wider use of protocol biopsies is knowledge of the benefits of intervention.
Protocol biopsies in kidney transplantation are safe and can yield unique information, but would be more widely used if the efficacy of interventions based on biopsy findings could be established.