Abstract:

Ｏｂｊｅｃｔｉｖｅ：To evaluate the value of protocol biopsy in patients after renal transplantation.
Ｍｅｔｈｏｄｏｌｏｇｙ：Searches were applied to the following electronic database：Medline，Embase Database，and Cochrane Library. Randomized controlled trials evaluating the value of protocol biopsy for renal allograft recipients were included. Data were extracted independently by two reviewer．The risk of bias of included studies was assessed by the the Cochrane collaborations tool for assessing risk of bias. Statistical analysis were performed with Ravman 50．
Ｒｅｓｕｌｔｓ：5 RCTs were included. Long term graft loss was significantly reduced (RR 043,95％CI 026 to 070，P<0001) by protocol biopsy after renal transplantation. Protocol biopsy may reduce the long term serum creatinine (WMD 3821 μmol/L, 95% CI 5483 to 2160，P<0001). For renal recipients whose basal immunosuppression was CNI (tacrolimus or cyclosporine). However, for those whose basal immunosuppression was tacrolimus, this effect was not notable.
Ｃｏｎｃｌｕｓｉｏｎ：Treatment of subclinical changes detected by protocol biopsy could significantly improve the graft survival and might improve the allograft function. The incidence of main complication of protocol biopsy was rare.