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.
Nephrology and Transplantation Department, Henri Mondor Hospital, AP-HP, Institut Francilien de Recherche en Néphrologie et Transplantation, Paris XII University, Créteil, France.
Marie
M
Matignon
Dominique
D
Desvaux
Laure-Hélène
LH
Noël
Françoise
F
Roudot-Thoraval
Eric
E
Thervet
Vincent
V
Audard
Karine
K
Dahan
Philippe
P
Lang
Philippe
P
Grimbert
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