Predictive morphological findings in "zero-hour" biopsies of renal allografts.
"Zero-hour" biopsies of 65 donors have been performed since 1994. Donor kidneys were categorized into five groups based on the morphological findings in "zero-hour" biopsies. No morphological abnormalities were found in 38% of the cases (group 1). Arteriosclerosis was present in 31% of donor kidneys (group 2). Specific morphological alterations, i.e. acute tubular necrosis [21.5%], tubulointerstitial nephritis [6.2%] or glomerulonephritis [3.1%] were detectable in the cases remained (group 3-5). During an average of 336 posttransplant days clinical and histological follow up was performed (50 rebiopsies). Statistical data of mismatch (1.4-2.0), average of donor/recipient age (35-42 years), cold and warm ischaemic time (1290 and 66 min) were comparable in all groups. According to our observations: 1. higher creatinin was found in grafts with arteriosclerosis (group 2) (p < 0.05), 2. there were more non-viable grafts and longer period of delayed graft function in acute tubular necrosis (group 3), 3 higher creatinin, rejections with the need of rehemodialysis were observed in four cases of tubulointerstitial nephritis (TIN-group 4). Glomerulonephritis (GN-group 5) grafts had only delayed graft function, however these groups were few for statistical evaluation. Biopsy complication in 1/115 cases was found (rebiopsy induced kidney haemorrhage). In conclusion, "zero-hour" biopsies can be useful and safe tools to predict early graft function. Besides "zero-hour" biopsies help the histological interpretation of consecutive graft rebiopsies.
Szánya
J
J
Department of Clinical Chemistry, University Medical School of Pécs, Hungary.
Szakály
P
P
Magyarlaki
T
T
Balogh
Z
Z
Nagy
J
J
Nagy
K K
KK
D000328:Adult; D000367:Age Factors; D001161:Arteriosclerosis / Q000097:blood / Q000473:pathology; D001706:Biopsy / Q000009:adverse effects; D003404:Creatinine / Q000097:blood; D005500:Follow-Up Studies; D005544:Forecasting; D005921:Glomerulonephritis / Q000473:pathology; D006084:Graft Rejection / Q000209:etiology; D006085:Graft Survival; D006470:Hemorrhage / Q000209:etiology; D006648:Histocompatibility; D006801:Humans; D016030:Kidney Transplantation / Q000473:pathology* / Q000502:physiology; D007683:Kidney Tubular Necrosis, Acute / Q000473:pathology / Q000503:physiopathology; D009395:Nephritis, Interstitial / Q000097:blood / Q000150:complications / Q000473:pathology; D009926:Organ Preservation; D006435:Renal Dialysis; D013997:Time Factors; D014184:Transplantation, Homologous
D003404:Creatinine