Renal biopsy donor group: the influence of glomerulosclerosis on transplant outcomes.
The UNOS donor population was examined from 1999 to 2002, and approximately 25% of the over 23,000 donors were biopsied (Bx). There was a significant trend (P < .001) of older donors, cardiovascular accident, and hypertension in the Bx group versus the non-Bx group. The percent GS was directly correlated (P < .001) to graft survival, delayed graft function, and primary nonfunction. Cox regression showed significant relative risk (RR) for >10% GS, hypertension, donors over the age of 50, and African American recipients. RR in donors with >10% GS could be ameliorated (P < .001) by choosing donors with <5 HLA-A, -B, or -DR mismatches (MM), or recipients who were nonsensitized, and/or first transplant. Risk should be managed in donors by choosing appropriate recipients and high-risk immunosuppresion protocols.
Cicciarelli
J
J
Department of Urology, USC Keck School of Medicine, Los Angeles, California 90089-9078, USA. cicciare@usc.edu
Cho
Y
Y
Mateo
R
R
El-Shahawy
M
M
Iwaki
Y
Y
Selby
R
R
D000328:Adult; D003404:Creatinine / Q000097:blood; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000473:pathology*; D006801:Humans; D007668:Kidney / Q000473:pathology*; D016030:Kidney Transplantation / Q000473:pathology / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012044:Regression Analysis; D012189:Retrospective Studies; D014019:Tissue Donors; D016896:Treatment Outcome
D003404:Creatinine