title: Histopathological analysis of pre-implantation donor kidney biopsies: association with graft survival and function in one year post-transplantation.
abstract: BACKGROUND
  Pre-implantation kidney biopsy is a decision-making tool when considering the use of grafts from deceased donors with expanded criteria, implanting one or two kidneys and comparing this to post-transplantation biopsies. The role of histopathological alterations in kidney compartments as a prognostic factor in graft survival and function has had conflicting results.
  
  
  OBJECTIVE
  This study evaluated the prevalence of chronic alterations in pre-implant biopsies of kidney grafts and the association of findings with graft function and survival in one year post-transplant.
  
  
  METHODS
  110 biopsies were analyzed between 2006 and 2009 at Santa Casa de Porto Alegre, including live donors, ideal deceased donors and those with expanded criteria. The score was computed according to criteria suggested by Remuzzi. The glomerular filtration rate (GFR) was calculated using the abbreviated MDRD formula.
  
  
  RESULTS
  No statistical difference was found in the survival of donors stratified according to Remuzzi criteria. The GFR was significantly associated with the total scores in the groups with mild and moderate alterations, and in the kidney compartments alone, by univariate analysis. The multivariate model found an association with the presence of arteriosclerosis, glomerulosclerosis, acute rejection and delayed graft function.
  
  
  CONCLUSIONS
  Pre-transplant chronic kidney alterations did not influence the post-transplantation one-year graft survival, but arteriosclerosis and glomerulosclerosis is predictive of a worse GFR. Delayed graft function and acute rejection are independent prognostic factors.
authors: Santa Casa Hospital of Porto Alegre.
authors: Karla Lais
authors: KL
authors: Pêgas
authors: University Hospital of Porto Alegre.
authors: Karine
authors: K
authors: Michel
authors: Santa Casa Hospital of Porto Alegre.
authors: Valter Duro
authors: VD
authors: Garcia
authors: Santa Casa Hospital of Porto Alegre.
authors: João
authors: J
authors: Goldani
authors: Santa Casa Hospital of Porto Alegre.
authors: Antônio
authors: A
authors: Bittar
authors: Santa Casa Hospital of Porto Alegre.
authors: Daniela
authors: D
authors: Seelig
authors: Federal University of Rio Grande do Sul.
authors: Eduardo
authors: E
authors: Cambruzzi
authors: Santa Casa Hospital of Porto Alegre.
authors: Elizete
authors: E
authors: Keitel
mesh_terms: D000328:Adult; D001706:Biopsy; D005260:Female; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000473:pathology* / Q000502:physiology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D013997:Time Factors