title: The prognostic value of pre-implantation graft biopsy on the outcomes of renal transplantations.
abstract: BACKGROUND
  The pre-implantation graft biopsy is an important tool for the selection of donors, providing objective information about graft function outcomes. The degree of histological lesions is related to the incidence of delayed graft function (DGF) and long-term survival of the graft.
  
  
  METHODS
  We analyzed 30 graft biopsy specimens by a semi-quantitative evaluation of chronic lesions. We evaluated the clinical characteristics of recipients, the presence of DGF, and the renal function in the immediate posttransplantation period, as well as month 3 and month 6 after transplantation.
  
  
  RESULTS
  Histological evaluation showed glomerulosclerosis score 0 in 77% versus score of 1 in 23%; fibrosis score 0 in 46.5% versus score 1 in 46.5% and score 2 in 7%; tubular atrophy score 0 in 53.5% versus score 1 in 36.5% and score 2 in 10%; vascular score 0 in 17% versus score 1 in 50% and score 2 in 33%. Approximately 33% of patients displayed DGF and 13% acute rejection episodes. There was a positive correlation between the presence of interstitial fibrosis and serum creatinine values at 3 (P = .01) and 6 months (P = .02). No correlation was observed between graft function and the presence of tubular atrophy, glomerulosclerosis, and vascular changes.
  
  
  CONCLUSIONS
  We observed that a large number of graft biopsy specimens (83%) displayed vascular changes related to the age of the donor. Only a minor degree of interstitial fibrosis, was related to better graft function. The presence of tubular atrophy, vascular changes, and glomerulosclerosis showed no impact on short-term graft function.
authors.affiliation: Department of Nephrology of Centro Hospitalar de Coimbra, Portugal. karinalopes17@gmail.com
authors.forename: K
authors.initials: K
authors.lastname: Lopes
authors.forename: R
authors.initials: R
authors.lastname: Alves
authors.forename: P A
authors.initials: PA
authors.lastname: Neto
authors.forename: F
authors.initials: F
authors.lastname: Macário
authors.forename: A
authors.initials: A
authors.lastname: Mota
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D006801:Humans; D007668:Kidney / Q000033:anatomy & histology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome