title: A histopathological score on baseline biopsies from elderly donors predicts outcome 1 year after renal transplantation.
abstract: Kidneys from elderly deceased patients and otherwise marginal donors may be considered for transplantation and a pretransplantation histopathological score for prediction of postoperative outcome is warranted. In a retrospective design, 29 baseline renal needle biopsies from elderly deceased donors (age: 63 ± 4 years; mean ± SD) were evaluated independently by three pathologists and with ten or more glomeruli and one artery present the biopsy was histopathologically scored (numeric score: 0-12) according to the presence of glomerulosclerosis, tubular atrophy, interstitial fibrosis and increased wall thickness of arteries and/or arterioles. Nineteen renal baseline biopsies from 15 donors (age: 64 ± 10 years) were included and following consensus the histopathological score was 4.3 ± 2.1 (intraclass correlation coefficient: 0.81; confidence interval: 0.66-0.92). The donor organs were used for single renal transplantation (recipient age: 47 ± 3 years). Two grafts were lost after the transplantation. In the remaining 17 recipients the 1-year creatinine clearance (54 ± 6 mL/min) correlated to the baseline histopathological score (r(2) = 0.59; p < 0.01). This study demonstrates that in elderly Danish donors a histopathological score on baseline renal needle biopsies, with at least ten glomeruli and one artery present, predicts graft function 1 year after transplantation.
authors.affiliation: Department of Pathology, Rigshospitalet, University of Copenhagen, Denmark. birgitte.groenkaer.toft@rh.regionh.dk
authors.forename: Birgitte G
authors.initials: BG
authors.lastname: Toft
authors.forename: Birgitte H
authors.initials: BH
authors.lastname: Federspiel
authors.forename: Søren S
authors.initials: SS
authors.lastname: Sørensen
authors.forename: Per
authors.initials: P
authors.lastname: Bagi
authors.forename: Henning B
authors.initials: HB
authors.lastname: Nielsen
authors.forename: Claus B
authors.initials: CB
authors.lastname: Andersen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D044963:Biopsy, Fine-Needle; D003718:Denmark; D005260:Female; D006085:Graft Survival; D006651:Histocytochemistry; D006801:Humans; D007668:Kidney / Q000473:pathology*; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D014019:Tissue Donors; D016896:Treatment Outcome