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Abstract
Kidney transplantation is the treatment of choice for end stage renal disease (ESRD). Nevertheless, renal allograft dysfunction is still common after transplantation and may be caused by rejection, calcineurin inhibitor (CNI) toxicity, recurrent or denovo renal disease. Graft biopsy is often used to determine its causes. In this study, ultrasound guided biopsy was done and studied pathologically. Acute rejection was found in 7 cases (23%) and interstitial fibrosis and tubular atrophy (IFTA) of various grades in 16%. Immunotherapy was modified in 28 cases (90%) following biopsy. chronic score correlated with both timing post transplantation and creatinine rise over baseline (p = 0.028, p = 0.037 respectively) allograft biopsy represents an indispensable diagnostic tool with significant impact on management approach