Comparison between clinical and histopathological scoring in cadaveric kidney transplantation and its correlation with posttransplant evolution.
BACKGROUND
There are several scoring systems, both clinical (Deceased Donor Score [DDS]) and histopathological (Remuzzi [REM]), that attempt to determine acceptability criteria for deceased donor kidney transplant. A retrospective study was performed among a group of kidney transplant recipients to evaluate posttransplant evolution with clinical and histopathological scores.


METHODS
Among 107 first deceased donor kidney transplant patients, 95 had undergone a pretransplant biopsy. Donor age was 38.46 +/- 16.9 years; recipient age: 49.2 +/- 16.3 years; DDS was 15.58 +/- 7.29. REM was 2.89 +/- 1.7. Delayed graft function was 64.2%. Induction therapy was administered to 49.5%. Cold ischemia time (CIT) was 1364 +/- 348 minute. Time on dialysis was 2275 +/- 1501 days. Induction therapy, immunosuppressive regimens, CIT, and time on dialysis were not significantly different among the groups. One-year patient and graft survival were 94.5% and 86%, respectively and 2-year values, 92.6% and 81%, respectively.


CONCLUSIONS
DDS showed a significant correlation with serum creatinine values over 1 and 2 years. REM did not show a significant association with any events. The differences were sustained after adjusting for other variables. Graft survival maintained a strong correlation with DDS categories and no association with REM. The clinical characteristics of a deceased donor appeared to be of greater importance than the biopsy findings in terms of posttransplant events.
Re
L
L
Instituto de Nefrología De Buenos Aires, Buenos Aires, Argentina. luis_s_re@yahoo.com.ar
Cicora
F
F
Petroni
J
J
Goldberg
J
J
Rial
M C
MC
Casadei
D
D
D000328:Adult; D000368:Aged; D002102:Cadaver; D003404:Creatinine / Q000097:blood; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology / Q000473:pathology* / Q000502:physiology*; D008875:Middle Aged; D012189:Retrospective Studies; D014019:Tissue Donors; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D003404:Creatinine