With the continuous maturation of kidney transplantation technology, the success rate and recent survival rate of kidney transplantation have been rising, and each transplantation center has achieved better results; however, the reasons affecting the long-term survival of transplanted kidney have not been effectively solved, resulting in the long-term survival rate of transplanted kidney has not been improved. What are the factors that affect long-term survival? The most important is chronic rejection, especially chronic humoral rejection, and drug nephrotoxicity are the main factors. Usually, once the transplanted kidney is implanted in a new body, it will be affected by various factors leading to different degrees of damage to the transplanted kidney, and the number of kidney units in the transplanted kidney will gradually decrease. Usually many kidney patients just think that there is no problem if the blood creatinine is normal, in fact, the blood creatinine level is normal until half of the transplanted kidney is damaged. Many patients just look at the creatinine good to think that there is no problem with the kidney, waiting for the creatinine to rise before they will know further to deal with. And some patients will have proteinuria and hematuria after kidney transplantation, then patients will be nervous, they will remember that they also have proteinuria and hematuria before the surgery, and after that will not also cause uremia, this kind of nervousness has been with patients, causing a great burden of thought. According to the current science and technology, when your examination reveals elevated blood creatinine, positive protein in urine and hematuria, you need to perform a transplant kidney biopsy in time to clarify the diagnosis and guide the treatment according to the diagnosis. For example, there are many factors that cause elevated blood creatinine (common causes of elevated blood creatinine after surgery), among which chronic rejection and drug toxicity cannot be distinguished in clinical and routine laboratory tests, so you need to rely on kidney biopsy; and BK virus nephropathy after kidney transplantation has the same clinical presentation as acute rejection, while the treatment is diametrically opposed. There are also many drug toxicity and rejection reactions that do not show elevated blood creatinine and abnormal urinalysis in the early stage, and by the time elevated blood creatinine appears, the damage is already obvious and some irreversible, leading to decreased long-term survival of the transplanted kidney. Therefore, the early detection of problems and timely correction of these problems is the fulfillment of the highest philosophy of the ancient practice of medicine in China – the disease of the untreated! Then there are two kinds of transplant kidney biopsy, one is the kidney transplant patients without any clinical manifestations, the examination is also normal, according to a certain time to perform transplant kidney biopsy, this is called routine kidney biopsy. The value of this kind of kidney biopsy is to discover the problem early and deal with it early. We often find subclinical rejection and early drug toxicity through routine puncture, and these diagnoses are treated early and the immunosuppressive regimen is changed in time to achieve better results. Another situation is that kidney transplant patients are found to have elevated blood creatinine, proteinuria and hematuria, which require a transplant kidney biopsy, which is even more necessary. Because there are various causes of high creatinine, proteinuria and hematuria, if we don’t do a transplant kidney biopsy, we can’t get the correct diagnosis and we can’t know the treatment plan. Just like shooting a gun without knowing the target, its effect is conceivable. Therefore, whether it is a routine biopsy or a problematic biopsy, it is necessary and the sooner the better! So is there any danger of transplant kidney biopsy? Many transplant kidney patients think that it is so easy to replace a kidney, will wearing a needle cause damage to the transplanted kidney? Simply put, a transplanted kidney has 500,000 kidney units, the transplanted kidney biopsy will generally take out 20-30 kidney units, that is, you have 500,000 yuan of savings, take out 20 yuan of it is not a great loss to you? So don’t worry about the transplant kidney biopsy causing damage to the transplanted kidney. Another question, what is the probability of problems with transplant kidney biopsy, generally speaking, transplant kidney biopsy is relatively simple and will not cause serious complications. The probability of hematuria caused by transplant kidney puncture is 6 per 1,000 in our kidney transplant center, and no one has had a transplant kidney removed as a result of a kidney biopsy. The whole puncture process takes about 5-10 minutes, and the actual puncture is only 1-2 seconds, and anesthetic drugs will be used before the procedure, which will not cause serious pain, so don’t worry. Then there are many patients who worry whether the transplant kidney puncture will be useless and will not have a guiding effect on diagnosis and treatment, so they might as well adjust their own medication. In a transplant center like ours, with a strong pathology laboratory as the foundation, a relatively clear diagnosis will be made for the vast majority of patients, and an individualized plan will be developed. Only a very small number of particularly difficult cases require in-depth analysis. In summary, transplant kidney biopsy is necessary and safe at the same time. At present, we recommend that a routine biopsy must be done half a year after kidney transplantation, and a transplanted kidney biopsy should be performed in time for high creatinine, hematuria and proteinuria, only through biopsy, the situation of the transplanted kidney can be clarified and the best strategy can be formulated to prolong the survival time of the transplanted kidney and make everyone’s happy life longer!