Arteriolar hyalinization predicts delayed graft function in deceased donor renal transplantation.
Delayed renal graft function (DGF) remains a largely unpredictable and burdensome consequence of deceased donor renal transplantation. There is growing evidence that histologic and molecular analyses of baseline donor kidney biopsies can predict both short- and long-term graft outcome. We performed histologic analyses of 172 preimplantation kidney biopsies to determine reliable histologic risk factors for DGF. Fifty-six recipients presented a DGF (incidence 32%). Univariate analysis revealed that arteriolar hyalinization (P=0.019), arterial intima fibrosis (0.004), donor age (P=0.001), duration of cold ischemia time (P=0.001), and recipient age (P=0.001) were significantly associated with DGF. Multivariate analysis revealed that the only independent histologic factor was arteriolar hyalinization (P=0.036). This histologic predictive factor, together with previously identified clinical risk factors, could guide clinical decisions regarding use, allocation, or immunosuppression protocols for minimization of DGF.
Matignon
Marie
M
Nephrology and Transplantation Department, Henri Mondor Hospital, AP-HP, Institut Francilien de Recherche en Néphrologie et Transplantation, Paris XII University, Créteil, France.
Desvaux
Dominique
D
Noël
Laure-Hélène
LH
Roudot-Thoraval
Françoise
F
Thervet
Eric
E
Audard
Vincent
V
Dahan
Karine
K
Lang
Philippe
P
Grimbert
Philippe
P
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001160:Arterioles / Q000473:pathology*; D001706:Biopsy; D002102:Cadaver; D002423:Cause of Death; D051799:Delayed Graft Function / Q000473:pathology*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006818:Hyalin / Q000378:metabolism*; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors