KIDNEY ALLOGRAFT PATHOLOGY DURING THE FIRST YEAR OF TRANSPLANT. THREE YEARS DATA FROM IRAQ

Kidney allograft biopsy is still an indispensable tool for transplant diagnostics, especially during the first year, as it helps to predict future graft function and survival. The annual rate of kidney transplants in Iraq for the year 2022 is 22.5 PMP. It is a live donor blood group compatible program. This study aims to describe the practice of allograft biopsy in Iraq and define the most common histology pattern in Iraqi patients during the first year. 

Kidney allograft pathology reports of 458 biopsies and 423 patients of three years were collected and analyzed. Thirty-five patients (8.27%) underwent two biopsies. The Banff 2017 diagnostic criteria were used to report and classify allograft histology. 

The study included 379 males, and the mean age of the study participants was 37.31+13.1 years. Thirty-five percent (163/458) of biopsies were performed in the first month. The mean time of performing biopsies is 15.18+9.8 days. All biopsies were for cause; graft dysfunction (99%) was the primary indication. An adequate biopsy was achieved in 77% of the study group. The most prevalent histological diagnoses were Acute T-cell rejection (168/36.68%) and acute tubular necrosis (113/24.67%), respectively.

Still, biopsy for cause is the main indication in Iraqi practice, with no tendency for performing surveillance biopsies. Acute T-cell-mediated rejection and acute tubular necrosis are the main histopathological patterns in the first year post-transplant.