The histology of solitary renal allografts at 1 and 5 years after transplantation

M. D. Stegall, W. D. Park, T. S. Larson, J. M. Gloor, L. D. Cornell, S. Sethi, P. G. Dean, M. Prieto, H. Amer, S. Textor, T. Schwab, F. G. Cosio

Research output: Contribution to journalArticlepeer-review

102 Scopus citations


Previous studies suggest that the majority of renal allografts are affected by progressive, severe chronic histologic injury, yet studies using current protocols are lacking. The goal of this study was to examine the prevalence and progression of histologic changes using protocol allograft biopsies at 1 and 5 years after solitary kidney transplantation in patients transplanted between 1998 and 2004. Chronic histologic changes generally were mild at both 1 and 5 years and were similar in deceased and living donor kidneys. The overall prevalence of moderate or severe fibrosis was 13% (60/447) at 1 year and 17% (60/343) at 5 years. In a subgroup of 296 patients who underwent both 1- and 5-year biopsies, mild fibrosis present at 1 year progressed to more severe forms at 5 years in 23% of allografts. The prevalence of moderate or severe arteriolar hyalinosis was similar in tacrolimus and calcineurin inhibitor-free immunosuppression. These results in the recent era of transplantation demonstrate fewer, less severe and less progressive chronic histologic changes in the first 5 years after transplantation than previously reported.

Original languageEnglish (US)
Pages (from-to)698-707
Number of pages10
JournalAmerican Journal of Transplantation
Issue number4
StatePublished - Apr 2011


  • Fibrosis
  • kidney transplantation
  • long-term outcomes
  • protocol renal allograft biopsies

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)


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