PROPORTION OF GLOMERULOSCLEROSIS IN PROCUREMENT WEDGE RENAL BIOPSY CANNOT ALONE DISCRIMINATE FOR ACCEPTANCE OF MARGINAL DONORS

作者：Eva Pokorn�, Stefan V tko, Maria Chadimov, Otto Sch ck, Henrik Ekberg · 发表于：Transplantation · 年份：2000 · DOI：10.1097/00007890-200001150-00008 · 被引用次数：127 · 研究领域：Renal Transplantation Outcomes and Treatments、Organ Donation and Transplantation、Renal and Vascular Pathologies

BACKGROUND: The shortage of available kidneys for renal transplantation could be addressed, to some extent, by expanding the criteria for acceptance of marginal donors. The study of these criteria is limited by the selection of grafts actually retrieved and transplanted, therefore reduced to a study of risk factors. We have evaluated the potential of procurement renal biopies as an instrument for acceptance or refusal of donor kidneys for transplantation. METHODS: This was a prospective study of a consecutive series of 200 donors. Biopsies were performed by wedge technique at the donor operation and were evaluated for proportion of glomerulosclerosis, vascular and tubular changes, and interstitial fibrosis. The study included 387 renal grafts with a representative biopsy, transplanted, and followed-up for survival and functional evaluation; 24 hr creatinine clearance at 1 and 3 weeks, and 3, 6, 12, 18, and 24 months. RESULTS: Factors associated with initial graft function included cold ischemia time, number of DR mismatches, tubular changes, although donor age showed the strongest correlation with short- and long-term level of graft function. DR mismatches and retransplantation appeared to be the only significant risk factors for graft loss. The proportion of glomerulosclerosis (mean 8%, range 0-48%) correlated with graft function in the simple regression analysis. However, when age was taken into account glomerulosclerosis did not correlate significantly with graft function....