ISSN: 2251-8363    eISSN: 2251-8819  
J Nephropathol. 2018;7(4):248-254.
doi:10.15171/jnp.2018.50

Original Article

Histological analysis of pre-transplant deceased donor renal biopsies and its association with long-term graft survival and function 

Karla Pegas 1 * , Roger Kist 2, Cynthia Keitel 2, Larissa Pacheco Larissa Pacheco 2, Eduardo Cambruzzi 3, Elizete Keitel 4

1 Universidade Federal De Ciencias Da Saude De Porto Alegre (UFCSPA), Santa Casa De Porto Alegre Hospital, Nossa Senhora Da Conceicao Hospital, Porto Alegre, Brazi
2 Santa Casa De Porto Alegre Hospital , Porto Alegre, Brazil
3 3 Universidade Federal De Rio Grande Do Sul, Complexo Hospitalar Santa Casa, Hospital Nossa Senhora Da Conceicao, Porto Alegre, Universidade Luterana Do Brasil, Canoas, Brasil
4 Universidade Federal De Ciencias Da Saude De Porto Alegre (UFCSPA), Santa Casa De Porto Alegre Hospital, Porto Alegre, Brazil
*Corresponding Author: Pathologist at Nossa Senhora da Conceição Hospital E-mail: lfp.voy@terra.com.br

Abstract

Background: Pre-implantation kidney biopsy is a diagnostic tool used for deciding whether to accept an expanded-criteria deceased donor graft. However, the study of histopathological lesions in renal compartments as prognostic factors for graft function and survival has led to conflicting results.

Objectives: This study aimed to evaluate the presence of chronic lesions in pre-implantation kidney biopsies and correlate the findings with graft function and survival at 1, 3, and 5 years post-transplantation.

Patients and Methods: Around 430 kidney biopsies from standard and expanded-criteria deceased donors were analyzed between 2006 and 2013 at the hospital Santa Casa de Porto Alegre. Lesions were graded according to the Banff criteria. The glomerular filtration rate (GFR) was calculated by the CKD-EPI equation. Graft survival was calculated by the Kaplan-Meier method. Clinical variables related to graft outcome were assessed by Cox regression analysis.

Results: The decrease in graft survival and function at the analyzed periods was related to a greater degree of chronic lesions in renal compartments. Glomerulosclerosis (GS) was an independent risk factor for graft loss.

Conclusions: Chronic lesions in any renal compartment should be taken into account in the clinical decision of accepting the kidney, but a greater weight should be given to GS. Kidney recipients with more than 25% GS had a less favorable outcome in our study

Implication for health policy/practice/research/medical education:

This research has an implication for health practice assisting physicians in the management of critically ill patients with endstage renal disease who require a renal graft to maintain life.

Please cite this paper as: Pegas K, Kist R, Keitel C, Pacheco L, Cambruzzi E, Keitel E. Histological analysis of pre-transplant deceased donor renal biopsies and its association with long-term graft survival and function. J Nephropathol. 2018;7(4):248- 254. DOI: 10.15171/jnp.2018.50.

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Submitted: 09 Feb 2018

Accepted: 26 Jun 2018
First published online: 11 Jul 2018
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