The Independent Effects of Procurement Biopsy Findings on 10-Year Outcomes of Extended Criteria Donor Kidney Transplants

Stewart, Darren; Foutz, J.; Kamal, Layla; Weiss, Samantha; McGehee, Harrison; Cooper, Matthew; Gupta, Gaurav

doi:10.1016/j.ekir.2022.05.027

Cited by 10 publications

(4 citation statements)

References 84 publications

(128 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Graft survival was lower after transplant of kidneys that underwent a procurement biopsy ( Figure KI 81 ), although the utility of procurement biopsy in informing appropriate organ use warrants further consideration. 5 …”

Section: Discussionmentioning

confidence: 99%

OPTN/SRTR 2021 Annual Data Report: Kidney

Lentine

Smith

Miller

et al. 2023

American Journal of Transplantation

Self Cite

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

OPTN/SRTR 2021 Annual Data Report: Kidney

Lentine

Smith

Miller

et al. 2023

American Journal of Transplantation

Self Cite

View full text Add to dashboard Cite

“…In a recent study [ 41 ], Stewart et al analyzed a large dataset of 3,851 ECDs recovered in the United States from 2008 to 2012 and reported a significant effect of glomerulosclerosis (GS>10%) on kidney graft survival, even after adjustment for potentially confounding donor and recipient variables. Conversely, the effects of interstitial fibrosis and vascular changes on the outcome were attenuated after adjustment.…”

Section: Resultsmentioning

confidence: 99%

European Society for Organ Transplantation (ESOT)-TLJ 3.0 Consensus on Histopathological Analysis of Pre-Implantation Donor Kidney Biopsy: Redefining the Role in the Process of Graft Assessment

Zaza¹,

Cucchiari

Becker

et al. 2023

Transpl Int

View full text Add to dashboard Cite

The ESOT TLJ 3.0. consensus conference brought together leading experts in transplantation to develop evidence-based guidance on the standardization and clinical utility of pre-implantation kidney biopsy in the assessment of grafts from Expanded Criteria Donors (ECD). Seven themes were selected and underwent in-depth analysis after formulation of PICO (patient/population, intervention, comparison, outcomes) questions. After literature search, the statements for each key question were produced, rated according the GRADE approach [Quality of evidence: High (A), Moderate (B), Low (C); Strength of Recommendation: Strong (1), Weak (2)]. The statements were subsequently presented in-person at the Prague kick-off meeting, discussed and voted. After two rounds of discussion and voting, all 7 statements reached an overall agreement of 100% on the following issues: needle core/wedge/punch technique representatively [B,1], frozen/paraffin embedded section reliability [B,2], experienced/non-experienced on-call renal pathologist reproducibility/accuracy of the histological report [A,1], glomerulosclerosis/other parameters reproducibility [C,2], digital pathology/light microscopy in the measurement of histological variables [A,1], special stainings/Haematoxylin and Eosin alone comparison [A,1], glomerulosclerosis reliability versus other histological parameters to predict the graft survival, graft function, primary non-function [B,1]. This methodology has allowed to reach a full consensus among European experts on important technical topics regarding pre-implantation biopsy in the ECD graft assessment.

show abstract

“…Additionally, Stewart et al. investigated and compared the predictive capacities of different items [ 13 ]. GS was found to be an independent risk factor for allograft survival.…”

Section: Discussionmentioning

confidence: 99%

Value of original and modified pathological scoring systems for prognostic prediction in paraffin-embedded donor kidney core biopsy

Tan,

Zhang,

Liu

et al. 2024

Renal Failure

View full text Add to dashboard Cite

Background No study has validated, compared and adapted scoring systems for prognosis prediction based on donor kidney core biopsy (CB), with less glomeruli than wedge biopsy. Methods A total of 185 donor kidney CB specimens were reviewed using seven scoring systems. The association between the total score, item scores, score-based grading, and allograft prognosis was investigated. In specimens with less than ten glomeruli (88/185, 47.6%), scoring systems were modified by adjusting weights of the item scores. Results The Maryland aggregate pathology index (MAPI) score-based grading and periglomerular fibrosis (PGF) associated with delayed graft function (DGF) (Grade: OR = 1.59, p < 0.001; PGF: OR = 1.06, p = 0.006). Total score, score-based grading and chronic lesion score in scoring systems associated with one-year and 3-year eGFR after transplantation. Total-score-based models had similar predictive capacities for eGFR in all scoring systems, except MAPI and Ugarte. Score of glomerulosclerosis (GS), interstitial fibrosis (IF), tubular atrophy (TA), and arteriolar hyalinosis (AH) had good eGFR predictive capacities. In specimens with less than ten glomeruli, modified scoring systems had better eGFR predictive capacities than original scoring systems. Conclusions Scoring systems could predict allograft prognosis in paraffin-embedded CB with ten more glomeruli. A simple and pragmatic scoring system should include GS, IF, TA and AH, with weights assigned based on predictive capacity for prognosis. Replacing GS scores with tubulointerstitial scores could significantly improve the predictive capacity of eGFR. The conclusion should be further validated in frozen section.

show abstract

The Independent Effects of Procurement Biopsy Findings on 10-Year Outcomes of Extended Criteria Donor Kidney Transplants

Cited by 10 publications

References 84 publications

OPTN/SRTR 2021 Annual Data Report: Kidney

OPTN/SRTR 2021 Annual Data Report: Kidney

European Society for Organ Transplantation (ESOT)-TLJ 3.0 Consensus on Histopathological Analysis of Pre-Implantation Donor Kidney Biopsy: Redefining the Role in the Process of Graft Assessment

Value of original and modified pathological scoring systems for prognostic prediction in paraffin-embedded donor kidney core biopsy

Contact Info

Product

Resources

About