title: Prevalence of abdominal aortic calcifications in older living renal donors and its effect on graft function and histology.
abstract: We assessed the prevalence of abdominal aortic calcification (AAC) in older living kidney donors and its effect on recipient eGFR and graft histology. A total of 292 consecutive living pairs with donor age ≥50 from 2003 to 2013 were identified (mean age 56; range 50-78; F/M: 1.8). Donor AAC was determined by prenephrectomy unenhanced CT. Recipient eGFR and spot urine protein: creatinine ratios (UPCRs) were recorded. A total of 180 recipients had 6-month protocol biopsies. AAC was present in 40.7% of donors, and they were older (58.6 versus 54.7 years old, P < 0.0001) and more likely to be male (77.6% vs. 37.3%, P = 0.004). There was no significant difference in eGFR or spot UPCR up to 36 months in recipients of allografts from donors with versus without AAC. At 6-month biopsy, there was a higher percentage of allografts with vascular fibrous intimal thickening and arteriolar hyaline thickening from donors with versus without AAC (vascular fibrous intimal thickening: 38.8% vs. 7.1% and arteriolar hyaline thickening: 35.8% vs. 7.1%; P < 0.001 for both). The presence of donor AAC predicts the presence of vascular disease [vascular fibrous intimal thickening (OR: 7.2; CI:2.9-17.9) and arteriolar hyaline thickening (OR:5.7; CI:2.3-14.1)] in allografts at 6 months. Donor AAC is predictive of renal vascular disease and may help to improve the screening of potential donors and inform post-transplant management.
authors.affiliation: Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA.
authors.forename: En-Haw
authors.initials: EH
authors.lastname: Wu
authors.affiliation: Department of Medicine, Division of Nephrology, MGH, Boston, MA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Wojciechowski
authors.affiliation: Department of Medicine, Division of Nephrology, UCSF, San Francisco, CA, USA.
authors.forename: Sindhu
authors.initials: S
authors.lastname: Chandran
authors.affiliation: Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA.
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Yeh
authors.affiliation: Department of Medicine, Division of Nephrology, UCSF, San Francisco, CA, USA.
authors.forename: Meyeon
authors.initials: M
authors.lastname: Park
authors.affiliation: Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA.
authors.forename: Antonio
authors.initials: A
authors.lastname: Westphalen
authors.affiliation: Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA.
authors.forename: Zhen J
authors.initials: ZJ
authors.lastname: Wang
mesh_terms: D000367:Age Factors; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D001027:Aortography; D001160:Arterioles / Q000473:pathology; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D001706:Biopsy; D003404:Creatinine / Q000652:urine; D046148:Donor Selection; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000000981:diagnostic imaging / Q000502:physiology / Q000648:ultrastructure; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011507:Proteinuria / Q000453:epidemiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D017539:Tunica Intima / Q000473:pathology; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology
chemical_list: D003404:Creatinine
keywords: imaging; kidney clinical; live donors; outcome