Histopathological analysis of pre-implantation donor kidney biopsies: association with graft survival and function in one year post-transplantation

Pêgas, Karla Laís; Michel, Karine; Garcı́a, Valter Duro; Goldani, J.J; Bittar, A.E; Seelig, Daniela; Cambruzzi, Eduardo; Keitel, Elizete

doi:10.5935/0101-2800.20140029

Cited by 6 publications

(7 citation statements)

References 22 publications

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“…Several studies have correlated CI with decreased graft survival . Other studies that found no association were able to show a correlation with a composite clinico‐pathologic score . Our KM estimator showed a correlation of CI with graft survival; however, after adjusting for potential cofounders, no association was evident.…”

Section: Discussioncontrasting

confidence: 67%

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Correlation of acute tubular injury in reperfusion biopsy with renal transplant outcomes

Oppong

Farber

Chervoneva

et al. 2016

Clinical Transplantation

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Acute tubular injury (ATI) is common at reperfusion, but its relationship to graft outcomes is unclear. Prior studies lack standardization of morphological assessments and included elements of acute and chronic tubular injury. This study aimed to evaluate the impact of ATI on graft outcomes. Reperfusion biopsies from 2004 to 2009 were retrospectively reviewed. ATI was assessed by a new standardized scoring system. We also assessed chronic injury (CI) by the Banff criteria. Outcomes evaluated included glomerular filtration rate (GFR) at 1 and 5 years and delayed graft function (DGF), acute rejection (AR), graft and patient survival. ATI did not correlate with DGF, AR, graft or overall survival. Mild-moderate ATI was not predictive of GFR post-transplant. Moderate-severe CI was associated with lower GFR at 5 years with a mean difference of -7.14 mL/min/1.73 m(2) (P=.04) and overall survival (HR 2.44, P=.01). Other predictors of graft function included donor age, DGF, and AR. Histologic criteria of ATI at implantation in the absence of donor demographics or clinical information do not provide sufficient predictability in outcomes after transplantation. On the other hand, histologic assessment of CI correlates with GFR and overall survival.

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Section: Discussioncontrasting

confidence: 67%

“…ATI in literature has been inconsistently associated with DGF, AR, and lower creatinine at various time points posttransplantation. 7,[22][23][24][25][26]28 10,17,46 Other studies that found no association 18,47 were able to show a correlation with a composite clinico-pathologic score. 18…”

Section: Discussionmentioning

confidence: 99%

Correlation of acute tubular injury in reperfusion biopsy with renal transplant outcomes

Oppong

Farber

Chervoneva

et al. 2016

Clinical Transplantation

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“…Rezaei et al30 showed that in the Cox model, four factors, including the presence of surgical or other complications, known primary disease, and donor–recipient relationship, had a significant association with patient survival, and seven factors, including the presence of surgical complications, known primary disease, donor–recipient relationship, gender, weight, same side transplanted kidney, and donor’s age, had significant relationship with graft survival 30. Pegas et al’s2 multivariate model found an association with the presence of arteriosclerosis, glomerulosclerosis, acute rejection, and delayed graft function.…”

Section: Discussionmentioning

confidence: 98%

“…This therapy exhibits a good cost/benefit ratio and can elevate the survival and quality of life of patients with ESRD. It has been estimated that the number of cases with chronic kidney disease and requiring a kidney transplant is increasing yearly by 8% in the USA 2. Iran is a pioneer in the Middle East region in performing kidney transplant for patients 3.…”

Section: Introductionmentioning

confidence: 99%

<p>The relation between zero-time pretransplant deceased donor renal biopsy and kidney transplant survival</p>

Tavakkoli

Yousefi

Mahdavi

et al. 2019

RRU

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Introduction There are several investigations about preimplantation biopsy results in alive donors. However, assessment of the biopsies in deceased donors’ kidney and its correlation with patient survival is limited. In this study, we evaluated the correlation between zero-time pretransplant kidney biopsy and survival of kidney in deceased donors. Patients and methods This was a cohort study conducted at Montaserieh Hospital, Mash-had, between January 2016 and December 2017. We included all brain dead patients who were referred to Montaserieh transplantation center. After vascular anastomosis of kidneys in recipient patients, in the operation room, and de-clumping of vessels, biopsies were taken from upper pole of donated kidney. Blocks of biopsies were evaluated by expert pathologists and then reported. We followed patients for 1 year and compared the pathologic findings and renal survival in them. Results The mean age of deceased donors was 32.32±1.49 years and that of the recipient patients was 36.33±1.27 years. Thirty-eight recipient patients (45.2%) were female and 46 were male (54.8%). The most pathologic pattern in our study was grade I separation, followed by blebs, dilatation, and loss of attenuation. We showed that most of the transplantations were safe after 1-year follow-up (85.7%) without any complications. We observed thrombosis in two cases (2.4%) and rejection of transplantation in ten patients (11.9%). Cox regression analysis showed that end-stage renal disease grade (HR =3.84, 95% CI =2.315–6.348; P <0.0001) and gender of the deceased donors (HR =0.34, 95% CI =0.145–0.797; P =0.013) were related to graft survival rate. Conclusion Only cast feature in pathologic exam was related to graft survival, which is a marker of tissue ischemia. There was no significant correlation between other histological findings and graft survival.

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“…Brazil lacks records on how many transplantation centres perform procurement biopsies or post‐reperfusion biopsies. According to published studies, some Brazilian centres perform procurement biopsies in organs from ECDs to evaluate the organ's viability for transplantation and thus as a tool to support the decision to accept or reject an organ …”

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confidence: 99%

Presence of arteriolar hyalinosis in post‐reperfusion biopsies represents an additional risk to ischaemic injury in renal transplant

et al. 2016

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Histopathological analysis of pre-implantation donor kidney biopsies: association with graft survival and function in one year post-transplantation

Abstract: Pre-transplant chronic kidney alterations did not influence the post-transplantation one-year graft survival, but arteriosclerosis and glomerulosclerosis is predictive of a worse GFR. Delayed graft function and acute rejection are independent prognostic factors.

Cited by 6 publications

References 22 publications

Correlation of acute tubular injury in reperfusion biopsy with renal transplant outcomes

Correlation of acute tubular injury in reperfusion biopsy with renal transplant outcomes

<p>The relation between zero-time pretransplant deceased donor renal biopsy and kidney transplant survival</p>

Presence of arteriolar hyalinosis in post‐reperfusion biopsies represents an additional risk to ischaemic injury in renal transplant

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