Degree of Glomerulosclerosis in Procurement Kidney Biopsies from Marginal Donor Kidneys and Their Implications in Predicting Graft Outcomes
<b>Background:</b> This study aimed to assess the association between the percentage of glomerulosclerosis (GS) in procurement allograft biopsies from high-risk deceased donor and graft outcomes in kidney transplant recipients. <b>Methods:</b> The UNOS database was used to id...
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MDPI AG
2020-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/5/1469 |
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| author | Wisit Cheungpasitporn Charat Thongprayoon Pradeep K Vaitla Api Chewcharat Panupong Hansrivijit Felicitas L. Koller Michael A Mao Tarun Bathini Sohail Abdul Salim Sreelatha Katari Lee S Cummings Eddie Island Jameson Forster Napat Leeaphorn |
| author_facet | Wisit Cheungpasitporn Charat Thongprayoon Pradeep K Vaitla Api Chewcharat Panupong Hansrivijit Felicitas L. Koller Michael A Mao Tarun Bathini Sohail Abdul Salim Sreelatha Katari Lee S Cummings Eddie Island Jameson Forster Napat Leeaphorn |
| author_sort | Wisit Cheungpasitporn |
| collection | DOAJ |
| description | <b>Background:</b> This study aimed to assess the association between the percentage of glomerulosclerosis (GS) in procurement allograft biopsies from high-risk deceased donor and graft outcomes in kidney transplant recipients. <b>Methods:</b> The UNOS database was used to identify deceased-donor kidneys with a kidney donor profile index (KDPI) score > 85% from 2005 to 2014. Deceased donor kidneys were categorized based on the percentage of GS: 0–10%, 11–20%, >20% and no biopsy performed. The outcome included death-censored graft survival, patient survival, rate of delayed graft function, and 1-year acute rejection. <b>Results:</b> Of 22,006 kidneys, 91.2% were biopsied showing 0–10% GS (58.0%), 11–20% GS (13.5%), >20% GS (19.7%); 8.8% were not biopsied. The rate of kidney discard was 48.5%; 33.6% in 0–10% GS, 68.9% in 11–20% GS, and 77.4% in >20% GS. 49.8% of kidneys were discarded in those that were not biopsied. Death-censored graft survival at 5 years was 75.8% for 0–10% GS, 70.9% for >10% GS, and 74.8% for the no biopsy group. Among kidneys with >10% GS, there was no significant difference in death-censored graft survival between 11–20% GS and >20% GS. Recipients with >10% GS had an increased risk of graft failure (HR = 1.27, <i>p</i> < 0.001), compared with 0–10% GS. There was no significant difference in patient survival, acute rejection at 1-year, and delayed graft function between 0% and 10% GS and >10% GS. <b>Conclusion:</b> In >85% KDPI kidneys, our study suggested that discard rates increased with higher percentages of GS, and GS >10% is an independent prognostic factor for graft failure. Due to organ shortage, future studies are needed to identify strategies to use these marginal kidneys safely and improve outcomes. |
| first_indexed | 2024-03-10T19:50:26Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T19:50:26Z |
| publishDate | 2020-05-01 |
| publisher | MDPI AG |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-3baefdbf0f68434a929fbe6f2184f6d32023-11-20T00:24:16ZengMDPI AGJournal of Clinical Medicine2077-03832020-05-0195146910.3390/jcm9051469Degree of Glomerulosclerosis in Procurement Kidney Biopsies from Marginal Donor Kidneys and Their Implications in Predicting Graft OutcomesWisit Cheungpasitporn0Charat Thongprayoon1Pradeep K Vaitla2Api Chewcharat3Panupong Hansrivijit4Felicitas L. Koller5Michael A Mao6Tarun Bathini7Sohail Abdul Salim8Sreelatha Katari9Lee S Cummings10Eddie Island11Jameson Forster12Napat Leeaphorn13Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USADivision of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USADivision of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USADivision of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USADepartment of Internal Medicine, University of Pittsburgh Medical Center Pinnacle, Harrisburg, PA 17105, USADepartment of Transplant and Hepatobiliary Surgery, University of Mississippi Medical Center, Jackson, MS 39216, USADivision of Nephrology, Division of Nephrology and Hypertension, Mayo Clinic, Jacksonville, FL 32224, USADepartment of Internal Medicine, University of Arizona, Tucson, AZ 85721, USADivision of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USARenal Transplant Program, School of Medicine/Saint Luke’s Health System, University of Missouri-Kansas City, Kansas City, MO 64110, USARenal Transplant Program, School of Medicine/Saint Luke’s Health System, University of Missouri-Kansas City, Kansas City, MO 64110, USARenal Transplant Program, School of Medicine/Saint Luke’s Health System, University of Missouri-Kansas City, Kansas City, MO 64110, USARenal Transplant Program, School of Medicine/Saint Luke’s Health System, University of Missouri-Kansas City, Kansas City, MO 64110, USARenal Transplant Program, School of Medicine/Saint Luke’s Health System, University of Missouri-Kansas City, Kansas City, MO 64110, USA<b>Background:</b> This study aimed to assess the association between the percentage of glomerulosclerosis (GS) in procurement allograft biopsies from high-risk deceased donor and graft outcomes in kidney transplant recipients. <b>Methods:</b> The UNOS database was used to identify deceased-donor kidneys with a kidney donor profile index (KDPI) score > 85% from 2005 to 2014. Deceased donor kidneys were categorized based on the percentage of GS: 0–10%, 11–20%, >20% and no biopsy performed. The outcome included death-censored graft survival, patient survival, rate of delayed graft function, and 1-year acute rejection. <b>Results:</b> Of 22,006 kidneys, 91.2% were biopsied showing 0–10% GS (58.0%), 11–20% GS (13.5%), >20% GS (19.7%); 8.8% were not biopsied. The rate of kidney discard was 48.5%; 33.6% in 0–10% GS, 68.9% in 11–20% GS, and 77.4% in >20% GS. 49.8% of kidneys were discarded in those that were not biopsied. Death-censored graft survival at 5 years was 75.8% for 0–10% GS, 70.9% for >10% GS, and 74.8% for the no biopsy group. Among kidneys with >10% GS, there was no significant difference in death-censored graft survival between 11–20% GS and >20% GS. Recipients with >10% GS had an increased risk of graft failure (HR = 1.27, <i>p</i> < 0.001), compared with 0–10% GS. There was no significant difference in patient survival, acute rejection at 1-year, and delayed graft function between 0% and 10% GS and >10% GS. <b>Conclusion:</b> In >85% KDPI kidneys, our study suggested that discard rates increased with higher percentages of GS, and GS >10% is an independent prognostic factor for graft failure. Due to organ shortage, future studies are needed to identify strategies to use these marginal kidneys safely and improve outcomes.https://www.mdpi.com/2077-0383/9/5/1469procurement kidney biopsyglomerulosclerosiskidney transplantationtransplantationoutcomes |
| spellingShingle | Wisit Cheungpasitporn Charat Thongprayoon Pradeep K Vaitla Api Chewcharat Panupong Hansrivijit Felicitas L. Koller Michael A Mao Tarun Bathini Sohail Abdul Salim Sreelatha Katari Lee S Cummings Eddie Island Jameson Forster Napat Leeaphorn Degree of Glomerulosclerosis in Procurement Kidney Biopsies from Marginal Donor Kidneys and Their Implications in Predicting Graft Outcomes Journal of Clinical Medicine procurement kidney biopsy glomerulosclerosis kidney transplantation transplantation outcomes |
| title | Degree of Glomerulosclerosis in Procurement Kidney Biopsies from Marginal Donor Kidneys and Their Implications in Predicting Graft Outcomes |
| title_full | Degree of Glomerulosclerosis in Procurement Kidney Biopsies from Marginal Donor Kidneys and Their Implications in Predicting Graft Outcomes |
| title_fullStr | Degree of Glomerulosclerosis in Procurement Kidney Biopsies from Marginal Donor Kidneys and Their Implications in Predicting Graft Outcomes |
| title_full_unstemmed | Degree of Glomerulosclerosis in Procurement Kidney Biopsies from Marginal Donor Kidneys and Their Implications in Predicting Graft Outcomes |
| title_short | Degree of Glomerulosclerosis in Procurement Kidney Biopsies from Marginal Donor Kidneys and Their Implications in Predicting Graft Outcomes |
| title_sort | degree of glomerulosclerosis in procurement kidney biopsies from marginal donor kidneys and their implications in predicting graft outcomes |
| topic | procurement kidney biopsy glomerulosclerosis kidney transplantation transplantation outcomes |
| url | https://www.mdpi.com/2077-0383/9/5/1469 |
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