title: Fibrous intimal thickening at implantation adversely affects long-term kidney allograft function.
abstract: BACKGROUND
  Kidneys from marginal and older donors are increasingly used to respond to the increasing demand for kidney transplants. This study evaluated the predictive value of intimal hyperplasia, as a marker of vasculopathy, in the renal allograft at the time of transplantation (transplantation) on the subsequent graft function (7 years).
  
  
  METHODS
  The intima/media ratio of the arterial walls (I/M) was morphometrically determined by the sectorial elliptic method, in 51 implantation biopsies. Two study groups were determined. Group 1, with I/M less than or equal to 0.47, was considered as the group with minimal vascular damage at transplantation. Group 2, with I/M more than 0.47, was considered as having vasculopathy at transplantation.
  
  
  RESULTS
  During the first 15 months, the estimated glomerular filtration rate improved in group 1 from 53+/-17 to 61+/-17 mL/min/1.73 m2, whereas it decreased from 51+/-21 to 46+/-14 mL/min/1.73 m2 in group 2. From 1 year posttransplantation, the estimated glomerular filtration rate (eGFR) was significantly higher in group 1 at all time points (6 month evaluation). The difference in graft function between the two groups (mean, 11 mL/min/1.73 m2) remained unchanged between 1 and 7 years posttransplantation. Among several clinical parameters investigated, blood pressure of the recipient significantly modulates the impact of preexisting vasculopathy on graft function.
  
  
  CONCLUSIONS
  Our data provide evidence that donor-related vasculopathy, at the time of transplantation, has a persistent significant impact on the subsequent graft function. This effect becomes only apparent at 1 year posttransplantation and is increased in recipients with inadequately controlled blood pressure.
authors.affiliation: Department of Nephrology, University Hospital Brussels, Laarbeeklaan, Brussels, Belgium.
authors.forename: Annemie T
authors.initials: AT
authors.lastname: Woestenburg
authors.forename: Gert A
authors.initials: GA
authors.lastname: Verpooten
authors.forename: Dirk K
authors.initials: DK
authors.lastname: Ysebaert
authors.forename: Eric A
authors.initials: EA
authors.lastname: Van Marck
authors.forename: Dierik
authors.initials: D
authors.lastname: Verbeelen
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Bosmans
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005355:Fibrosis / Q000473:pathology / Q000601:surgery; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000502:physiology*; D007674:Kidney Diseases / Q000473:pathology* / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D013997:Time Factors; D014184:Transplantation, Homologous