Biopsy of cadaver renal allografts may aid in the assessment of marginal allografts. However, the use of this approach is not clear. This study presents the outcome of institution of a protocol for back table biopsy of renal allografts during organ procurement.
Methods: Data from Lifelink Organ Donation Network records and the ANZDATA registry were analysed.
Results: The biopsy rate of renal allografts increased from 0.8% to 15.6% (P=0.01). The discardment rate of potential renal allografts increased slightly with 1.9% being discarded based on the biopsy result and 3.8% being discarded for other reasons. Under the biopsy protocol, 28/40 (70%) of donors with renal allograft biopsies had <20% glomerulosclerosis. The incidence of both delayed graft function and non-function was higher (P=0.014 and P=0.033, respectively) for the protocol biopsied allografts compared with the other non-biopsied allografts. One-year renal allograft survival was not significantly different between the protocol biopsied allografts versus the other non-biopsied allografts.
Conclusions: A biopsy protocol for marginal potential renal allografts leads to acceptable allograft outcomes without significantly increasing allograft discardment.