RENAL-TRANSPLANT BIOPSY - WHAT DOES IT TELL

The value of the renal allograft biopsy has been significantly enhance d by several developments in 1997 including the following: the first c onvincing demonstration that molecular biology techniques can be appli ed to renal allograft tissue to obtain a diagnosis of acute rejection with high sensitivity and specificity; the development of an improved, internationally agreed classification of kidney transplantation patho logy ('Banff 1997'); and significant new insights into the specific pa thology of chronic rejection, involving splitting and lamination of pe ritubular capillary basement membranes and the presence of increased a poptotic cell death, Although it is predictable that long-term technol ogy might eliminate the need for renal allograft biopsies altogether, in the short term these new breakthroughs will greatly increase the va lue of this procedure in the management of renal transplant patients.