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논문분류	춘계학술대회 초록집
제목	Clinical Usefulness of Kidney Biopsy in Liver Transplant Recipients with Renal Impairment
저자	Jong Hoon Lee1, Yul Hee Cho1, Bum Soon Choi1, Cheol Whee Park1, Chul Woo Yang1,Yong-Soo Kim1, Young Kyoung Kim3, Jong Young Choi2, Dong Goo KIm3, Byung Ha Chung1
출판정보	2013; 2013(1):
키워드	신조직검사, 신부전, 간이식/Kidney biopsy, Renal impairment, Liver transplantation
초록	With marked increase the liver transplantation (LT), patients who showed concomitant renal problem increased as well. However, there is limited data about the role of kidney biopsy (KB) in those patients. The aim of this study is to investigate the usefulness of KB in LT recipients. Eleven LT recipients who underwent KB due to proteinuria (n=4), renal dysfunction (n=7) were included. We reviewed the clinical and histological data of those patients. Especially, we analyzed the role of KB in treatment of renal problem of those patients. Four patients with Ig A nephropathy were treated with angiotensin receptor blockers and none of them reached end stage renal disease (ESRD). One patient had already DM with overt proteinuria before LT, his indication for KB was elevated Cr level. Biopsy demonstrated DM nephropathy (DMN) and he reached ESRD. One patient with DMN had new onset DM after LT and reached ESRD after 11 years of KB. One patient who had CNI toxicity treated with reduced dose of CNI, showed favorable response. One patient with focal proliferative glomerulonephritis with cellular crescent did not respond to high dose steroid and cyclophosphamide and started maintenance hemodialysis. Three patients (27%) who reached End-stage renal disease (ESRD) had advanced DMN or cellular crescent suggesting severe inflammatory process There was no major bleeding complication requiring transfusion or embolization. Renal histology is variable, not limited to CNI toxicity and histologic diagnosis have impact on therapeutic strategies and prognosis.
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