We have performed 115 "zero-hour" biopsies of transplanted kidneys since 1994. Donor kidneys were divided into five groups, based on the morphological findings of "zero-hour" biopsies. No morphological abnormalities were found in 38.26% of the cases (group 1).
Arteriolosclerosis was present in 22.61% of donor kidneys (group 2). Specific morphological alterations, i.e. acute tubular
necrosis (24.35%),
tubulointerstitial nephritis (5.22%) or
glomerulonephritis (9.56%) were detectable in the remaining cases (groups 3-5). During an average of 644 days after
transplantation clinical and histological follow-up were performed. According to our observations: 1. Higher
creatinine was found in patients with grafts with
arteriolosclerosis (group 2). 2. There were more non-viable grafts and longer periods of
delayed graft function in patients with acute tubular
necrosis (group 3). 3. Higher serum
creatinine, more frequent rejections with the need of secondary
hemodialysis were observed in patients who received a kidney with "zero-hour" biopsy of
tubulointerstitial nephritis (group 4). 4. The only complication observed in patients with
glomerulonephritis donor kidneys was delayed functioning of the graft (group 5). Biopsies did not cause complication in any of our patients. In conclusion, "zero-hour" biopsies can be useful and safe tools to predict early graft function. Besides, "zero-hour" biopsies help histological interpretation of consecutive graft re-biopsies.