title: Correlation between dual kidney biopsy in expanded-criteria donors and transplant survival.
abstract: OBJECTIVE
  The aim was to study the relation between same-donor renal biopsies and analyze whether the score influences graft survival.
  
  
  METHODS
  We retrospectively reviewed histologic results of expanded-criteria donors and the graft survival in patients followed at Reina Sofia Hospital (Cordoba, Spain) from January 2004 to October 2012. We analyzed clinical and demographic variables from the donors, as well the association between the scores of same-donor biopsies who had different scores for each kidney and the graft survival with a t test for paired data. A Kaplan-Meier with log-rank test was performed between the higher-score and the lower-score groups. We excluded retransplantation and those who received a combined transplantation (liver or pancreas).
  
  
  RESULTS
  We analyzed 168 kidneys that had been biopsied, from 84 donors. Of the whole sample, 35.7% (n = 30) had the same score for each kidney, whereas 64.3% (n = 54) had discrepancies. In this second group, 81.8% (n = 44) had a difference of 1 point, and the remaining 18.2% (n = 10) had a larger difference. Both kidneys were suitable for transplantation in 72.7% of cases (n = 40), only 1 in 14.5% (n = 8), and none in 12.7% (n = 7). For analyzing the survival of the paired kidneys there were 48 kidneys from 24 donors with a different score for each kidney. We observed a difference in favor of the better scores, with a difference of 11 months up to the time of the analysis (P = .045). We found no significant differences in the log-rank test between the survival rate for the group with a less favorable score (95% confidence interval [CI], 61.26-95.67) versus those with a more favorable score (95% CI, 66.76-93.03).
  
  
  CONCLUSIONS
  A high percentage of biopsies had a different score for the 2 kidneys from the same donor. This difference was important for graft survival. We therefore recommend doing a biopsy of both kidneys.
authors: Urology Unit, Reina Sofía University Hospital, Córdoba, Spain. Electronic address: josehgr@gmail.com.
authors: J H
authors: JH
authors: García-Rubio
authors: J Ruiz
authors: JR
authors: García
authors: P Campos
authors: PC
authors: Hernández
authors: J Márquez
authors: JM
authors: López
authors: F Anglada
authors: FA
authors: Curado
authors: M Leva
authors: ML
authors: Vallejo
authors: J C Regueiro
authors: JC
authors: López
authors: E Gómez
authors: EG
authors: Gómez
authors: P
authors: P
authors: Aljama
authors: M J Requena
authors: MJ
authors: Tapia
mesh_terms: D000368:Aged; D001706:Biopsy; D046148:Donor Selection; D005260:Female; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000473:pathology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome