Outcome of Kidney Transplantation from Older Living Donors: Histological Evaluation Using Zero-Time Biopsy Specimens
1Department of Urology, Tokyo Women's Medical University, Tokyo, Japan
2Department of Pathology, Tokyo Women's Medical University, Tokyo, Japan
3Department of Pathology, St. Marianna University, School of Medicine, Kawasaki, Japan.
Meeting: 2015 American Transplant Congress
Abstract number: B186
Keywords: Age factors, Donors, Graft function, Histology, marginal
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
OBJECTIVE: The relationship between preimplantation biopsy and graft outcome in kidney transplantations from older living donors has not been studied yet. We reviewed graft outcomes and histological evaluations of zero-time biopsy specimens in kidney transplantations from older living donors.
METHODS: We retrospectively evaluated 764 consecutive recipients at our institute. The subjects in the recipient cohort were stratified according to donor age as follows: very old living donors (VOLD: age ≥ 75 years), older living donors (OLD: 65 years ≤ age < 75 years), and younger living donor (YLD: age < 65 years). Histological evaluation results of zero-time biopsy specimens, early posttransplantation outcomes, patient survival, and graft survival were compared. Histological changes in each evaluated component of the kidney tissue were scored from 0 to 3.
RESULTS: Of the 764 kidney transplantations, 12 were VOLDs, 117 were OLDs, and 635 were YLDs. In the histological evaluations, scores for glomeruli, vessels, tubules, and connective tissue were significantly higher in the VOLDs and OLDs than in the YLDs. The histological scores of the VOLDs were similar to those of the OLDs. No significant differences were found between the 3 groups regarding the incidences of acute graft rejection and slow graft function. No significant differences in patient survival were observed between the 3 groups. Graft survival was lower in the VOLD transplantations than in the YLD transplantations. However, the OLD transplantations were associated with similar graft survival rate as that in the YLD transplantations.
CONCLUSIONS: In the zero-time biopsies, the kidneys from the living donors aged 65 years or older had histological problems compared with those from living donors younger than 65 years. However, the long-term survival of the kidney grafts from the OLDs, but not from the VOLDs, was excellent. This may indicate that utilization of VOLDs should be carefully considered when determining the appropriate donor/recipient combination.
To cite this abstract in AMA style:
Omoto K, Toki D, Okumi M, Shimizu T, Ishida H, Honda K, Koike J, Tanabe K. Outcome of Kidney Transplantation from Older Living Donors: Histological Evaluation Using Zero-Time Biopsy Specimens [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/outcome-of-kidney-transplantation-from-older-living-donors-histological-evaluation-using-zero-time-biopsy-specimens/. Accessed May 9, 2025.« Back to 2015 American Transplant Congress