Histopathological analysis of pre-implantation donor kidney biopsies: association with graft survival and function in one year post-transplantation

Jornal Brasileiro de Nefrologia

Karla Lais Pêgas¹  Karine Michel¹  Valter Duro Garcia¹  João Goldani¹  Antônio Bittar¹  Daniela Seelig¹  Eduardo Cambruzzi¹  Elizete Keitel¹ 

关键词: biopsy;    glomerular filtration rate;    graft rejection;    kidney transplantation;    prognosis;    biópsia;    prognóstico;    rejeição de enxerto;    taxa de filtração glomerular;    transplante de rim;   

DOI  :  10.5935/0101-2800.20140029

来源: SciELO

【 摘 要 】

Introduction: Pre-implantation kidney biopsy is a decision-making tool when considering the use of grafts from deceased donors with expanded criteria, implanting one or two kidneys and comparing this to post-transplantation biopsies. The role of histopathological alterations in kidney compartments as a prognostic factor in graft survival and function has had conflicting results. Objective:This study evaluated the prevalence of chronic alterations in pre-implant biopsies of kidney grafts and the association of findings with graft function and survival in one year post-transplant. Methods:110 biopsies were analyzed between 2006 and 2009 at Santa Casa de Porto Alegre, including live donors, ideal deceased donors and those with expanded criteria. The score was computed according to criteria suggested by Remuzzi. The glomerular filtration rate (GFR) was calculated using the abbreviated MDRD formula. Results:No statistical difference was found in the survival of donors stratified according to Remuzzi criteria. The GFR was significantly associated with the total scores in the groups with mild and moderate alterations, and in the kidney compartments alone, by univariate analysis. The multivariate model found an association with the presence of arteriosclerosis, glomerulosclerosis, acute rejection and delayed graft function. Conclusion:Pre-transplant chronic kidney alterations did not influence the post-transplantation one-year graft survival, but arteriosclerosis and glomerulosclerosis is predictive of a worse GFR. Delayed graft function and acute rejection are independent prognostic factors.

【 授权许可】

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