title: Rapid Resolution of Donor-Derived Glomerular Fibrin Thrombi After Deceased Donor Kidney Transplantation.
abstract: The aim of this study was to determine the clinical and histologic outcomes related to transplanting kidneys from deceased donors with glomerular fibrin thrombi (GFT). We included all cases transplanted between October 2003 and October 2014 that had either a preimplantation biopsy or an immediate postreperfusion biopsy showing GFT. The study cohort included 61 recipients (9.9%) with GFT and 557 in the control group without GFT. Delayed graft function occurred in 49% of the GFT group and 39% in the control group (p = 0.14). Serum creatinine at 1, 4, and 12 months and estimated GFR at 12 months were similar in the two groups. Estimated 1-year graft survival was 93.2% in the GFT group and 95.1% in the control group (p = 0.22 by log-rank). Fifty-two of the 61 patients in the GFT group (85%) had a 1-month protocol biopsy, and only two biopsies (4%) showed residual focal glomerular thrombi. At the 1-year protocol biopsy, the prevalence of moderate to severe interstitial fibrosis and tubular atrophy was 24% in the GFT group and 30% in the control group (p = 0.42). We concluded that GFT resolves rapidly after transplantation and that transplanting selected kidneys from deceased donors with GFT is a safe practice.
authors.affiliation: Department of Surgery, Mayo Clinic, Phoenix, AZ.
authors.forename: R K
authors.initials: RK
authors.lastname: Batra
authors.affiliation: Department of Medicine, Mayo Clinic, Phoenix, AZ.
authors.forename: R L
authors.initials: RL
authors.lastname: Heilman
authors.affiliation: Laboratory Medicine and Pathology, Mayo Clinic, Phoenix, AZ.
authors.forename: M L
authors.initials: ML
authors.lastname: Smith
authors.affiliation: Department of Medicine, Mayo Clinic, Phoenix, AZ.
authors.forename: L F
authors.initials: LF
authors.lastname: Thomas
authors.affiliation: Department of Medicine, Mayo Clinic, Phoenix, AZ.
authors.forename: H A
authors.initials: HA
authors.lastname: Khamash
authors.affiliation: Department of Surgery, Mayo Clinic, Phoenix, AZ.
authors.forename: N N
authors.initials: NN
authors.lastname: Katariya
authors.affiliation: Department of Surgery, Mayo Clinic, Phoenix, AZ.
authors.forename: W R
authors.initials: WR
authors.lastname: Hewitt
authors.affiliation: Department of Surgery, Mayo Clinic, Phoenix, AZ.
authors.forename: A L
authors.initials: AL
authors.lastname: Singer
authors.affiliation: Department of Surgery, Mayo Clinic, Phoenix, AZ.
authors.forename: A K
authors.initials: AK
authors.lastname: Mathur
authors.affiliation: Department of Medicine, Mayo Clinic, Phoenix, AZ.
authors.forename: J
authors.initials: J
authors.lastname: Huskey
authors.affiliation: Department of Medicine, Mayo Clinic, Phoenix, AZ.
authors.forename: H A
authors.initials: HA
authors.lastname: Chakkera
authors.affiliation: Department of Surgery, Mayo Clinic, Phoenix, AZ.
authors.forename: A
authors.initials: A
authors.lastname: Moss
authors.affiliation: Department of Surgery, Mayo Clinic, Phoenix, AZ.
authors.forename: K S
authors.initials: KS
authors.lastname: Reddy
mesh_terms: D000328:Adult; D002102:Cadaver; D005260:Female; D005337:Fibrin / Q000032:analysis*; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000517:prevention & control*; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D007677:Kidney Function Tests; D007678:Kidney Glomerulus / Q000378:metabolism / Q000473:pathology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000378:metabolism / Q000473:pathology*; D014019:Tissue Donors / Q000600:supply & distribution*
chemical_list: D005337:Fibrin
keywords: biopsy; clinical research/practice; donors and donation: deceased; kidney transplantation / nephrology