Arteriosclerosis in kidneys from healthy live donors: comparison of wedge and needle core perioperative biopsies.
BACKGROUND
Although risks associated with live kidney donation are low, there are few pathologic studies of kidneys from live donors, and possible risk factors for development of hypertension or renal insufficiency remain unknown. There are many studies of histopathologic changes in deceased donor kidneys and how these changes affect subsequent graft function; most are based on wedge rather than needle core biopsies.


OBJECTIVE
To examine the frequency and severity of arterial fibrointimal thickening and other pathologic lesions in kidneys from healthy live donors and compare wedge and needle core biopsies as methods for evaluating these changes.


METHODS
For 36 of 332 live donor renal transplantations performed from January 2004 through November 2006, a wedge biopsy of the transplanted kidney was done prior to and/or after implantation, and a needle core biopsy was done postimplantation or during the ensuing 7 days. For these 36 allografts, we compared pathologic features of the wedge and core perioperative biopsies.


RESULTS
Findings on core and wedge biopsies were similar, except for arterial fibrointimal thickening. Moderate thickening (Banff cv2) was present on 13 core biopsies, and mild thickening (cv1) was present on another 10; by contrast, no wedge biopsies showed cv2 lesions, and only 8 showed cv1. Arterial thickening on core but not wedge biopsies correlated significantly with increasing patient age.


CONCLUSIONS
The findings indicate that needle core biopsies are superior to wedge biopsies for evaluating vascular changes in donor kidneys, and they suggest a need for studies correlating such changes with long-term outcomes of live donors, particularly older donors.
Haas
Mark
M
Department of Pathology, Johns Hopkins University School of Medicine, 600 N Wolfe St, Pathology 712, Baltimore, MD 21287, USA. mhaas@jhmi.edu
Segev
Dorry L
DL
Racusen
Lorraine C
LC
Bagnasco
Serena M
SM
Melancon
J Keith
JK
Tan
Miguel
M
Kraus
Edward S
ES
Rabb
Hamid
H
Ugarte
Richard M
RM
Burdick
James F
JF
Montgomery
Robert A
RA
D000328:Adult; D000368:Aged; D001158:Arteries / Q000473:pathology; D001161:Arteriosclerosis / Q000473:pathology*; D001707:Biopsy, Needle; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000473:pathology*; D007674:Kidney Diseases / Q000473:pathology*; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009927:Tissue and Organ Procurement; D017539:Tunica Intima / Q000473:pathology