EARLY MEASUREMENT OF INTERSTITIAL FIBROSIS PREDICTS LONG-TERM RENAL-FUNCTION AND GRAFT-SURVIVAL IN RENAL-TRANSPLANTATION

This study investigated the relationships between renal allograft inte rstitial fibrosis, renal function and graft survival. A total of 107 c onsecutive renal transplant recipients immunosuppressed with cyclospor in were studied. Needle core transplant biopsies were performed before operation and at 1, 6 and 12 transplantation. Allograft fibrosis was histomorphometric analysis of graft interstitial volume fraction, Rena l function was measured by isotopic glomerular filtration rate (GFR) m easurement at the same time points, Interstitial volume fraction was a lready high in preperfusion biopsies, significantly increased with tim e but stabilized at 6 months after transplantation. GFR correlated neg atively with interstitial volume fraction at 6 months (P = 0.05). Inte rstitial volume fraction at 1 month was not a useful predictor of subs equent graft survival but for allografts surviving to 6 months an inte rstitial volume fraction above 25 per cent predicted significantly poo rer survival (P = 0.04). It provides an objective measure of chronic a llograft damage and may prove to be a useful surrogate endpoint in the study of therapeutic intervention.