Background: There is lack of consensus in the perceived accuracy of frozen biopsy interpretation. Interobserver variability in assessment of pre-implantation biopsies limits its value to predict organ quality. We tested pre-implantation histopathological parameters with early graft function Method: We analyzed data on 152 deceased donor kidney recipients transplanted between 1/2012 -2/2016. Each biopsy was read by two different renal pathologists. Biopsies were scored using two criteria. Banff criteria scored 0-3 for changes associated with (<5%,6-25,26-50, >50% of area involved and arteriolar scores mild for 1, moderate>1and severe for multiple arterioles). Parameters included in the Banff scores are interstitial fibrosis, tubular atrophy, arterial intimal fibrosis, arteriolar hyalinosis,chronic glomerular matrix. In addition chronic allograft damage index (CADI) incorporated inflammation and percentage global glomerular sclerosis.We tested correlation of each scoring system independently for graft function. Donor characteristics as KDPI, recipient characteristics as EPTS, CIT, and pump readings were tested for correlation to histopathological scoring system and each variable for graft function. Results:CADI score which incorporated the percentage glomerular sclerosis and inflammation performed better compared to Banff score in predicting early graft function and showed a trend toward negative correlation with early eGFR (p=0.06,p=0.10, p=0.02,p=0.10) at 1 month, 3 months, 6 months and 12 months respectively . There was strong negative correlation with KDPI and eGFR at 12 months ( p=0.001), Cold ischemia time ( P=0.014) pump flow( p=0.037) and resistive index ( p=0.014) for graft function at 12 months.Interobserver correlation between the two pathologists for total Banff score (ICC=79%) and CADI score ( ICC=92%) were excellent. Conclusion: A multiparametric approach may be developed by incorporating pre-implantation biopsy information along with important clinical variables to predict graft outcome. our study is limited by organ usage bias, recipient and post transplant variables affecting graft function.

CITATION INFORMATION: Zachariah M, Yip C, Zachariah M, Mallawaarachchi I, Dweivedi A, Patel S, Gundroo A, Tomaszewski J, Lin L, Shirley C. Correlation of Donor Clinical and Histopathological Characteristics with Graft Function in Kidney Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).

« Back to 2017 American Transplant Congress