In addition to the usual clinical and biological criteria for quality assessment of cadaveric kidney allografts, baseline biopsy might take a compelling place in donor selection and the prediction of recipient outcome. This review on kidney graft assessment focuses on the usefulness of baseline biopsy as it may impact on the following: donor status concerning cold ischemic and reperfusion injuries, incidentally found donor nephropathy with unknown consequence on kidney graft outcome, acute and chronic donor changes that might interfere with early and late kidney graft survival, and chronic donor changes that take part of chronic allograft lesions and may influence analysis of subsequent biopsies. Finally, judicious allocation of kidney grafts from marginal donors requires discriminating histologic tools.
*Department of Renal and Pancreatic Transplantation, †Department of Pathology, Université Catholique de Louvain Medical School, Brussels, Belgium
Correspondence to J. Malaise, MD, Department of Renal and Pancreatic Transplantation, Université Catholique de Louvain Medical School, Avenue Hippocrate, 10/2207, 1200 Brussels, Belgium; e-mail: firstname.lastname@example.org