Presence of arteriolar hyalinosis in post‐reperfusion biopsies represents an additional risk to ischaemic injury in renal transplant

Matos, Ana Cristina Carvalho de; Câmara, Niels Olsen Saraiva; Requião-Moura, Lúcio R.; Tonato, Eduardo José; Filiponi, Thiago Corsi; Souza-Durao, Marcelino; Malheiros, Denise Maria Avancini Costa; Fregonesi, Mauricio; Borrelli, Milton; Pacheco-Silva, Álvaro

doi:10.1111/nep.12699

Cited by 8 publications

(6 citation statements)

References 43 publications

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“…While we found that both arterial intimal fibrosis and arteriolar hyalinosis correlate with graft function, our multivariate analysis points to arterial intimal fibrosis as the main histological factor related to graft function. Our study differs from that of Matos et al [15] by also matching procurement with reperfusion biopsy data.…”

Section: Discussion/conclusionmentioning

confidence: 80%

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Arterial Intimal Fibrosis in Reperfusion Biopsy Correlates with Graft Function after Kidney Transplant

Perez‐Gutierrez

Danz

Chang

et al. 2021

Nephron

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Introduction: Alterations to the procurement biopsy are one of the main reasons that kidneys are not suitable for transplant and are discarded. The literature on procurement and reperfusion biopsy is inconsistent and heterogeneous. The objective of this study is to describe the correlation of the different histological characteristics detected by the procurement and reperfusion biopsies in relation to graft function. Methods: This is a retrospective cohort study of deceased donor kidney transplants performed from 2013 to 2017. All of the different histological components of procurement and reperfusion biopsies were analyzed with nonparametric tests and multivariate regressions. Graft function was expressed as glomerular filtration rate (GFR) at 1, 3, 6, and 12 months after transplant. All tests were based on a level of significance of α = 0.05. Results: A comparison of procurement and reperfusion biopsies revealed that 60.4% of the grafts exhibited more arterial intimal fibrosis and 55.6% more arteriolar hyalinosis in the reperfusion biopsy than in the procurement biopsy. Arterial intimal fibrosis in reperfusion biopsy correlated with GFR at all time points, and it was the only histological characteristic of the reperfusion biopsy that remained significant in multivariate analysis. Glomerulosclerosis in the procurement biopsy correlated with graft function and remained significant in multivariate analysis, but only at 6 months. Arterial intimal fibrosis in the reperfusion biopsy is significantly associated with graft function independently of clinical characteristics. Conclusion: Our study highlights the importance of arterial intimal fibrosis in predicting kidney function after transplant. Because arterial intimal fibrosis is a chronic change not related to ischemia-reperfusion injury, the differences between the 2 biopsies may be due to the biopsy technique. In order to increase the prognostic accuracy of the procurement biopsy, the technique should be improved to better evaluate the vasculature.

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Section: Discussion/conclusionmentioning

confidence: 80%

“…Matos et al [15] also investigated the individual components of reperfusion biopsies. They found that arteriolar hyalinosis alone is predictive of delayed graft function and graft failure at 1 year.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Arterial Intimal Fibrosis in Reperfusion Biopsy Correlates with Graft Function after Kidney Transplant

Perez‐Gutierrez

Danz

Chang

et al. 2021

Nephron

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“…The relationship between donor-related factors and initiation of chronic renal allograft dysfunction has been extensively studied, and baseline histology obtained from 0-hour biopsies has been demonstrated to predict graft outcomes. Glomerulosclerosis (GS), [6][7][8] vascular narrowing, [7][8][9][10][11][12][13] acute and chronic tubulointerstitial lesions, 7,8,[10][11][12] and several composite scoring systems, which integrate histopathological findings in different kidney compartments, 6,[14][15][16][17][18][19][20] have been assessed as predictive variables for immediate, short-, and long-term graft function and survival. Regarding the relationship between donor-related factors and renal graft function after deceased KTx, the timing of evaluation varies according to the study.…”

Section: Introductionmentioning

confidence: 99%

Arteriolar hyalinization at 0‐hour biopsy predicts long‐term graft function in deceased kidney transplantation

Murata,

Tasaki,

Saito

et al. 2023

Int J of Urology

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ObjectivesRegarding the relationship between donor kidney quality and renal graft function after deceased kidney transplantation (KTx) following donation after cardiac death (DCD), the evaluation timing varies depending on the study. Evaluation of histology and changes in long‐term renal graft function is limited.MethodsA retrospective single‐center study included 71 recipients who underwent 0‐hour biopsy for KTx from DCD. The recipients were divided into two groups to evaluate factors related to renal graft function (study1). The two groups were categorized as stable graft function and poor graft function with the change of estimated glomerular filtration rate (eGFR) after KTx. The recipients were then divided into four groups to assess whether the factors identified in study1 were related to the change in long‐term renal graft function (study2). They were categorized as follows: Improved, Stable, Deteriorated, and Primary non‐function with the change of eGFR after KTx.ResultsIn study1, donor age ≥ 50 years (29.5% vs. 65.2%; p = 0.09), banff arteriolar hyalinosis (ah) score (0.66 ± 0.78 vs. 1.2 ± 1.0; p = 0.018), and presence of glomerulosclerosis (43.2% vs. 76.2%; p = 0.017) were significant risk factors for poor long‐term graft function. When the recipients were divided into four groups, the severity of ah correlated well with changes in long‐term renal function.ConclusionsWe can predict the shift in long‐term renal graft function after KTx from DCD according to the severity of ah by 0‐hour biopsy.

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“…(Am J Pathol 2019, 189: 2503e2515; https://doi.org/ 10.1016/j.ajpath.2019.08.006) Arteriolar hyalinosis, or hyaline arteriolosclerosis, is a vascular lesion often found in the kidney in aging and hypertension, 1 or caused by calcineurin inhibitor use after transplantation. 2,3 It consists of accumulated hyaline material, which is thought to be the result of subendothelial leakage of plasma proteins 4,5 and of subsequently increased extracellular matrix production by smooth muscle cells (SMCs). 6 In the kidney, the afferent arterioles are the most commonly affected vessels, likely because of their role of major resistance arterioles, placing great local stress on the endothelium.…”

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confidence: 99%

Klotho Deficiency Induces Arteriolar Hyalinosis in a Trade-Off with Vascular Calcification

Mencke

Umbach

Wiggenhauser

et al. 2019

The American Journal of Pathology

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Presence of arteriolar hyalinosis in post‐reperfusion biopsies represents an additional risk to ischaemic injury in renal transplant

Cited by 8 publications

References 43 publications

Arterial Intimal Fibrosis in Reperfusion Biopsy Correlates with Graft Function after Kidney Transplant

Arterial Intimal Fibrosis in Reperfusion Biopsy Correlates with Graft Function after Kidney Transplant

Arteriolar hyalinization at 0‐hour biopsy predicts long‐term graft function in deceased kidney transplantation

Klotho Deficiency Induces Arteriolar Hyalinosis in a Trade-Off with Vascular Calcification

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