Histopathological Pattern of Live Related Renal Allograft Biopsy in A Tertiary Care Hospital of Dhaka, Bangladesh

Abstract

Background: Renal allograft dysfunction is a significant challenge in kidney transplantation, often leading to graft failure. Histopathological evaluation of renal biopsies plays a critical role in identifying the underlying causes of dysfunction. This study aimed to analyze the histopathological patterns of renal biopsies in live-related renal allograft dysfunction. Methods: This retrospective cross-sectional study was carried out at the Department of Nephrology, Evercare Hospital, Dhaka, Bangladesh, over a period spanning from January 2018 to December 2024. The study included 96 adult patients who had undergone renal transplantation and subsequently underwent allograft biopsies. These biopsies were performed to investigate graft dysfunction without any obvious cause. The pathological findings were categorized based on the updated Banff classification system. Data analysis was conducted using SPSS version

23.0. Results: In this study of 96 renal allograft recipients, the majority were male (78%) with a mean age of 36.4±3.8 years. The mean serum creatinine increased from 1.33±0.21 mg/dL to 2.39±0.37 mg/dL during biopsy. According to Banff classification, 34.4% had antibody-mediated rejection (ABMR), 26.0% had T-cell-mediated rejection (TCMR), and 7.3% showed interstitial fibrosis/tubular atrophy (IF/TA). Conclusion: Renal biopsy in live-related renal allograft dysfunction revealed common patterns of antibody-mediated rejection, T-cell-mediated rejection, and interstitial fibrosis/tubular atrophy. Elevated serum creatinine levels correlated with graft dysfunction, emphasizing the importance of early detection for improved management.