Proteinuria in Diseased Kidney Transplant Donors for Prediction of Chronic Lesions in Pre-Transplant Biopsies – A Prospective Observational Study
1Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria, 2Department of Pathology, Medical University of Vienna, Vienna, Austria, 3Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden, 4Division of Clinical Chemistry, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
Meeting: 2022 American Transplant Congress
Abstract number: 740
Keywords: Biopsy, Donation, Graft function, Organ Selection/Allocation
Topic: Clinical Science » Kidney » 32 - Kidney Deceased Donor Selection
Session Information
Session Name: Kidney Deceased Donor Selection
Session Type: Poster Abstract
Date: Saturday, June 4, 2022
Session Time: 5:30pm-7:00pm
Presentation Time: 5:30pm-7:00pm
Location: Hynes Halls C & D
*Purpose: Pre-transplant kidney graft biopsies have been suggested for organ quality assessment. Data on the association between donor proteinuria and organ quality of deceased donors are not available.
*Methods: In this prospective study we analyzed 147 pre-transplant kidney biopsies from 88 deceased adult donors procured and transplanted consecutively at the Medical University Vienna between July 2017 and May 2020. Glomerular, interstitial, vascular and tubular lesions were scored from 0 to 5 with each ascending score representing a 20% increase in organ damage and added to a total chronic lesion score. Donor proteinuria was assessed by urinary-protein-to-creatinine ratio (UPCR).
*Results: The median chronic lesion score was 2 (IQR 1-4) and the UPCR was 382 mg/dL (IQR 222-703). There was a positive correlation between UPCR and the number of chronic lesions (β 0.15, 95%CI 0.03-0.28; p=0.019). Biopsies with two or more lesions had a median UPCR of 486 mg/dl (IQR 251-717) compared to 274 mg/dL (IQR 211-556; p=0.016) in biopsies with less than two lesions. The risk for detection of two or more lesions rose by 18% for every log increase in UPCR (RR 1.18, 95%CI 1.03-1.25; p=0.017). Multivariable and sensitivity analysis revealed an independent and robust association between chronic lesions and UPCR.
*Conclusions: Donor UPCR is associated with chronic lesions in pre-transplant deceased donor kidney graft biopsies. This finding justifies further investigation of donor proteinuria for the assessment of organ quality and outcome.
To cite this abstract in AMA style:
Haupenthal F, Kläger J, Bauernfeind F, Heinzel A, Doberer K, Mayer K, Naar L, Eigenschink M, Hu K, Regele H, Szekeres T, Reindl-Schwaighofer R, Bond G. Proteinuria in Diseased Kidney Transplant Donors for Prediction of Chronic Lesions in Pre-Transplant Biopsies – A Prospective Observational Study [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/proteinuria-in-diseased-kidney-transplant-donors-for-prediction-of-chronic-lesions-in-pre-transplant-biopsies-a-prospective-observational-study/. Accessed May 9, 2025.« Back to 2022 American Transplant Congress