Significance of Time-Zero Biopsy Findings for Deceased Donor Kidney Transplantation, The

A. Lee, M. Kim, H. Jeong, D. Joo, S. Lee, B. Kim, K. Huh, Y. Kim, K. Park

Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, Korea
Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
Department Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea

Meeting: 2013 American Transplant Congress

Abstract number: D1541

Introduction: Donor organ qualities from deceased donors affect graft survival after kidney transplantation, especially for marginal donors. The authors considered that relations between donor-related factors and histological findings might provide useful information regarding early graft outcomes.

Patients and Methods: Between December 2006 and July 2011, 135 recipients of deceased donor kidneys were included, and data concerning donor-related clinical characteristics and histological findings of time-zero biopsies categorized using Banff criteria were included in the analysis.

Results: Mean age of deceased donors was 44.3±12.34 years. Global glomerulosclerosis (GS, 38.5%), tubular atrophy (CT, 37.8%), interstitial fibrosis (CI, 23%), vascular fibrous intimal thickening (CV, 21.5%), arteriolar hyaline thickening (AH, 25.9%), interstitial inflammation (I, 20%) were the major pathologic findings of time-zero biopsies. A multivariate logistic regression analysis showed terminal donor creatinine level, a recipient history of diabetes, and AH was significantly independent predictors of delayed graft function. The only independent risk factor of a decrease of eGFR at 1 year was interstitial fibrosis.

Table 1: Multivariate analysis of eGFR at 6 months and 1 year
	eGFR at 6month		eGFR at 1year
parameter	B (SE)	p-value	B (SE)	p-value
Donor clinical
Age	-4.03 (1.28)	0.002	-2.56 (1.32)	0.055
History of diabetes	1.79 (6.54)	0.785
Use of inotropics	-14.72 (6.04)	0.016
Histological
Glomerulosclerosis (GS)	-0.82 (1.84)	0.655	0.10 (1.86)	0.957
Tubular atrophy (CT)	3.80 (4.30)	0.377	5.86 (4.45)	0.195
Interstitial fibrosis (CI)	-8.22 (4.85)	0.092	-12.36 (5.06)	0.016
Arteriolar hyaline thickening (AH)	-9.96 (4.01)	0.014	-7.63 (4.00)	0.059
Interstitial inflammation (I)	-6.45 (4.44)	0.149	-7.60 (4.58)	0.100

SE; standard error, Donor ages were categorized as <34, 35-44, 45-54, and ≥55 years

Conclusion: Considerations of clinico-histological findings were found to be valuable for predicting early graft outcome after deceased donor kidney transplantation.

To cite this abstract in AMA style:

Lee A, Kim M, Jeong H, Joo D, Lee S, Kim B, Huh K, Kim Y, Park K. Significance of Time-Zero Biopsy Findings for Deceased Donor Kidney Transplantation, The [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/significance-of-time-zero-biopsy-findings-for-deceased-donor-kidney-transplantation-the/. Accessed November 23, 2024.

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