More than Twenty Years’ Experience with “Zero-Hour” Transplant Kidney Biopsy

“Zero-hour” biopsies of 968 transplant kidney have been performed since 1994. Donor kidneys were categorized into five groups based on the morphological findings in “zero-hour” biopsies. No morphological abnormalities were found in 40.5% of the cases. Arteriosclerosis was seen in 21.3% of donor kidneys. Acute tubular necrosis 27.8%, chronic tubulointerstitial nephritis 3.9% or glomerulonephritis 6.5% were detectable in the cases remained. Not significant differences were found in individual groups concerning basic disease, duration of supplementary kidney treatment prior to transplantation, mean age of recipients and HLA, B and DR mismatches. During the follow-up period (on the average 1764 days) 733 biopsies were performed. Side effect due to the performance of “zero-hour” biopsy was not observed. Massive haematuria resulting bladder tamponade occurred only once during re-biopsies. We found very worse early and long-time results at the chronic tubulointerstitial group. Arteriosclerosis in the transplant kidney is one of the alloantigen independent factors of the chronic allograft nephropathy. “Zero-hour” biopsies could be useful and safe tools to predict early graft function. Additionally, “zero-hour” biopsies help the histological interpretation of consecutive graft re-biopsies.