Frozen section or rapid permanent biopsies of donor kidneys are frequently obtained for higher risk kidneys. We sought to investigate agreement between the procurement donor biopsy (DB) results and our hospital's post-reperfusion biopsies (PRB).

Methods: After IRB approval, retrospective chart review of all deceased donor kidney transplants from January 2012-July 2016 was performed. Biopsies from adult single kidney recipients with both a DB and PRB were studied. Result reporting varied among organ procurement organizations, but both interstitial fibrosis and glomerulosclerosis were reliably reported and therefore used for comparison. Ordinal values of glomerulosclerosis percentage (0=0-5%, 1=6-10%, 2=11-15%, 3=16-20%, 4=21-25%, 5=26-30%, 6=>30%) and fibrosis grade (0=none, 1=mild, 2=moderate, 3-severe) were analyzed in comparing likeness.

Results: Of the 444 kidneys transplanted 133 (30%) had both a DB and PR; 115 reported glomerulosclerosis, and 127 reported fibrosis. DB and PRB glomerulosclerosis scores were statistically correlated (Kendall's tau-b, p=0.028) whereas fibrosis was not (p=0.659) (Table 1). 50.9% of biopsies displayed no difference in glomerulosclerosis between DB and PRB and only 10 (4%) biopsies had a greater than 10% variation (Figure 1). For fibrosis, 55 (43.7%) biopsies had identical scores, while 50 (36.6%) had higher and 21 (16.7%) had lower scores on PRB.Conclusions: DB and PRB results showed reasonable correlation for glomerulosclerosis assessment, while interstitial fibrosis grading differed between DB and PRB over half the time. These results suggest that donor institution biopsy results are helpful for graft acceptance decisions, as long as the potential for small changes in glomerulosclerosis or fibrosis score is acceptable.

CITATION INFORMATION: Barrett M, Prater A, Farkash E, Christopher D, Fritze D, Matusko N, Sung R, Woodside K. Reliability of Donor Kidney Biopsies from Time of Organ Recovery Compared to Immediate Post-Reperfusion Biopsies. Am J Transplant. 2017;17 (suppl 3).

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