"Protocol biopsies after kidney transplantation: emphasis on interstitial fibrosis/ tubular atrophy and peritubular capillary loss in relation to clinical parameters" 

The only life-saving treatment for kidney failure is a kidney transplantation. However, a transplanted kidney does not last indefinitely. In this thesis protocol kidney biopsies, taken in the first year after transplantation, were studied. The aim was to investigate the relation of the degree of kidney damage, seen in the biopsy, and both short- and long-term renal function after transplantation. The studies focussed on fibrosis and peritubular density in the biopsies. De main results were that fibrosis develops mainly in kidneys from donors after circulatory death in the first year after transplantation. More fibrosis at 1-year after transplantation is associated with worse 10-year graft survival. Furthermore, there is a decrease in peritubular capillary density early after transplantation in kidneys from donors after circulatory death, in kidneys with delayed graft function and after rejections. Protocol biopsies provide a useful tool to study early pathological parameters for renal function and might be implemented in clinical care in the future.