A Comparative Analysis of Histological Scoring in Living Donor Renal Transplants from Donors Above and Below 60 Years of Age

A. Ghazanfar,^1,2 F. Kazmi,² A. Bagul,¹ M. Morsy,¹ J. Popoola.¹

¹Renal Medicine and Transplant Surgery, St Georges Healthcare NHS Trust, London, United Kingdom
²St Georges University of London, London, United Kingdom.

Meeting: 2015 American Transplant Congress

Abstract number: B181

Keywords: Biopsy, Donation, Kidney transplantation

Session Information

Session Name: Poster Session B: Living Donor Issues 1

Session Type: Poster Session

Date: Sunday, May 3, 2015

Session Time: 5:30pm-6:30pm

Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

BACKGROUND AND OBJECTIVES: World Health Organisation estimates that the absolute number of people aged 60yrs and over will increase from 605-million to  2-billion over the next 30yrs. This aging population will have significant impact on selection and acceptance of living donor renal transplants (LDRTx). Studies have suggested that the number of glomeruli-per-kidney and the mean glomerular volume negatively correlate with age beyond 60yrs. These kidneys have a lower functional nephron mass and have double risk of DGF when compared to younger donors. Short and long term graft outcome from below and above 60yrs LDRTx are well documented but histological information of renal allograft biopsy is not avaiable. In this present study we have compared day zero and 3 moths renal transplant biopsies among these groups.

MATERIALS AND METHODS: We retrospectively analyzed data of 222 LDRTx performed between Jan-2008 and Dec-2012. Transplants lost because of acute thrombosis or hyperacute rejections were excluded. We had 51 LDRTx from donors 60yrs and above. We used Remuzzi and BANFF criteria to compare their day-zero and 3-months post-transplant biopsies. SPSS software system was used for analysis.

RESULTS: There was 100% one-year graft survival in both groups. Three-year graft survival was 98% in above 60yrs as compared to 96% in below 60yrs. Histological results are summarized below

Comparison of day 0 and 3 months renal transplant biopsies using Reumzzi scoring
Timing of biopsy	Scoring	> 60yrs	18-59yrs	Significant
Reumzzi day zero	0-3 (Mild)	49	169	0.622
	4-6 (Moderate)	2	2	0.832
Reumzzi 3 months	0-3 (Mild)	50	170	0.744
	4-6 (Moderate)	1	1

Comparison of day zero and 3 months renal Transplant biopsies using BNAFF scoring
Timing of biopsy	Scoring	> 60yrs	18-59yrs	Significant
BNAFF day zero (Acute)	No	46	161	0.640
	Mild	4	9	0.732
	Moderate	2	1	0.840
BNAFF day zero (Chronic)	No	47	159	0.762
	Mild	3	2	0.668
	Moderate	1	3	0.788
BNAFF 3 months (Acute)	No	49	159	0.688
	Mild	1	8	<0.05
	Moderate	1	5	<0.05
BNAFF 3 months (Chronic)	No	45	164	0.766
	Mild	4	4	<0.05
	Moderate	2	3	0.604

CONCLUSION: The histological data supports clinical outcomes in LDRTx from donors above 60yrs. These organs thus form an important resource to bridge the gap between supply and demand.

To cite this abstract in AMA style:

Ghazanfar A, Kazmi F, Bagul A, Morsy M, Popoola J. A Comparative Analysis of Histological Scoring in Living Donor Renal Transplants from Donors Above and Below 60 Years of Age [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/a-comparative-analysis-of-histological-scoring-in-living-donor-renal-transplants-from-donors-above-and-below-60-years-of-age/. Accessed November 21, 2024.

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