Mesangial IgA Deposition in Zero-Hour Graft Biopsy: Two Cases

Zero-hour graft biopsies are done following post-revascularisation after the vessel anastomosis during the kidney transplantation. We report here two cases of kidney recipients in whom mesangial immunoglobulin A (IgA) deposition was observed in zero-hour graft biopsies. The first case was a 47-year-old woman who underwent hemodialysis treatment due to the end stage renal failure (ESRF) secondary to polycystic kidney disease. She had kidney transplantation from a cadaveric donor on May 21, 2014 at our hospital. The second case was a 50-year-old woman. She also had ESRF secondary to polycystic kidney disease. She had preemptive kidney transplantation from a living donor on January 14, 2015 at our hospital. Zero-hour graft biopsies were done during the kidney transplantation in both of the cases. Mesangial matrix expansion and mesangial IgA deposition were observed. The second biopsy was done sixth months later due to proteinuria in our first case. A mild degree of mesangial matrix expansion was observed but mesangial IgA deposition had disappeared. Zero-hour graft biopsies are very important in the follow-up period of patients after kidney transplantation. They also allow us to understand whether the pathological findings that are observed in subsequent graft biopsies are of new onset or transmitted from the donor.