Association Between Histological Abnormalities in Time-Zero Renal Biopsies and Post-Donation eGFR in Live Donors

L. Fahmy, A. Massie, B. Orandi, S. Bagnasco, J. Alejo, B. Boyarsky, S. Anjum, R. Montgomery, N. Dagher, D. Segev.

Johns Hopkins, Baltimore.

Meeting: 2015 American Transplant Congress

Abstract number: 103

Keywords: Donation, Histology, Kidney

Session Information

Session Name: Concurrent Session: Kidney: Living Donor Issues I

Session Type: Concurrent Session

Date: Sunday, May 3, 2015

Session Time: 4:00pm-5:30pm

Presentation Time: 5:12pm-5:24pm

Location: Terrace IV

Time-zero biopsies (T0-RBx) of live-donor kidneys may reveal histological abnormalities at the time of organ recovery. The association between T0-RBx and subsequent kidney function in live donors remains unknown.

METHODS: We abstracted % glomerulosclerosis (GS) and extent of interstitial fibrosis (IF) from T0-RBx of 220 live donors at our center and linked to donor estimated glomerular filtration rate (eGFR) obtained from post-donation medical records with median 7.2 years of followup time. We used multilevel mixed-effects linear regression to model the association between biopsy results and eGFR trajectory over time.

RESULTS: Median (IQR) GS was 4.8% (0%-9.7%). Minimal IF was observed in 72.5% and mild/moderate IF was observed in 27.6% of biopsies. In an age-unadjusted model with GS and IF, a 10% increase in GS was associated with eGFR decrease of _0.33 2.28 _4.22 (p=0.02, Table 1). Mild/moderate IF (vs minimal) was associated with decreased eGFR (_-7.48 -3.80 _-0.13, p=0.03), but there was no evidence of association after adjustment for GS (_-5.78 -1.82 _2.14, p=0.4) (Table 1). Both GS and IF were statistically insignificant after adjusting for age (Table 1). Interaction terms were also statistically insignificant.

CONCLUSION: Mild GS in live donors was associated with decreased short-term post-donation eGFR; however this association disappeared after adjusting for age.

GS and IF models
	eGFR(mL/min/1.73m² )
	Model 1	Model 2	Model 3	Model 4
Per year (0-10y)	_0.670.96_1.25**	_0.650.94_1.23**	_0.670.96_1.25**	_0.620.90_1.18**
Per year (>10y)	_-1.98-0.69_0.60	_-1.98-0.69_0.60	_-2.01-0.73_0.56	_-2.06-0.78_0.51
GS (per 10%)	_-4.42-2.64_-0.86**		_-4.22-2.28_-0.33	_-2.62-0.85_0.91
Mild/Moderate IF (vs Minimal)		_-7.48-3.80_-0.13	_-5.78-1.82_2.14	_-4.53-1.00_2.53
Age (per 10y)				_-6.88-5.45_-4.02**

Bold = p<0.05; ** = p<0.001

To cite this abstract in AMA style:

Fahmy L, Massie A, Orandi B, Bagnasco S, Alejo J, Boyarsky B, Anjum S, Montgomery R, Dagher N, Segev D. Association Between Histological Abnormalities in Time-Zero Renal Biopsies and Post-Donation eGFR in Live Donors [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/association-between-histological-abnormalities-in-time-zero-renal-biopsies-and-post-donation-egfr-in-live-donors/. Accessed November 23, 2024.

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