Association between Histological Abnormalities in Time-Zero Renal Biopsies and Post-donation eGFR in Live Donors

Renal Biopsy;Histological Abnormality;Kidney Living Donor;post-donation eGFR;Epidemiology

Fahmy, Lara M.

Johns Hopkins University

关键词: Renal Biopsy;    Histological Abnormality;    Kidney Living Donor;    post-donation eGFR;    Epidemiology;   

Others  :  https://jscholarship.library.jhu.edu/bitstream/handle/1774.2/39248/FAHMY-THESIS-2015.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: JOHNS HOPKINS DSpace Repository

【 摘 要 】

Time-zero renal biopsies (T0-RBx) of living donor kidneys may reveal histological abnormalities at the time of organ recovery.The association between T0-RBx and long-term post-donation kidney function in living donors remains unclear.Methods:We abstracted the extent of glomerulosclerosis, interstitial fibrosis, mesangial matrix increase, arteriolar hyalinosis, and intimal thickening from T0-RBx of 253 living donors at our institution.We then constructed a binary composite score, moderate/severe abnormality (MSA), from the factors abstracted and linked it to donor estimated glomerular filtration rate (eGFR) obtained from post-donation medical records with median (interquartile range) follow-up time of 7.1 (4.2 – 9.2) years.We used multilevel mixed-effects linear regression to model the association between MSA and eGFR trajectory over time.Results:22.9% of donors had one or more MSAs.In an unadjusted model, there was no evidence of difference in post-donation eGFR between MSA and no MSA donors (difference in eGFR -3.17 mL/min/1.73m2, p = 0.1, 95% CI: -7.10 – 0.76 ).The association was further attenuated after adjusting for donor age at transplant, sex, and race (difference in eGFR0.04mL/min/1.73m2, p = 0.99, 95% CI: -3.57 – 3.64).Conclusions:There is no evidence of association between minor histological abnormalities at time of organ donation and post-donation eGFR in living donors.Among donors cleared to donate, biopsy results do not predict post-donation renal health.