Pretransplant Biopsy of Marginal Kidneys: Is It Necessary?

Teixeira, André Costa; Ferreira, Eugénia; Marques, Maria Guedes; Rodrigues, Luís; Santos, Lídia; Romãozinho, Catarina; Afonso, Nuno; Sousa, Vinícius Rodrigues de; Ferreira, Cristina Targa; Macário, Fernando; Alves, Rui; Figueiredo, Arnaldo

doi:10.1016/j.transproceed.2019.02.023

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…On the other hand, despite the widespread use of pre-implantation biopsies, there is no consensus on their value in predicting allograft survival. 34,35 Regarding the ideal donor data of the original donor in case 4, a 20% chronic tubulo-interstitial damage 4 and 12 months after retransplantation of this graft seems not adequate and shows that a well preserved pre-donation kidney function 9 years after the first transplantation (serum creatinine of 1.0 mg/dl, measured creatinine clearance of 49 ml/min, proteinuria within the normal range 4 months before donation) does not necessarily indicate the rate of chronic tissue damage despite a nearly full HLA A/B/C/DR/DQ match. Furthermore, chronic changes in kidney grafts are common (29% of the grafts after ½-1 year with a gradual increase to 63% after 10 years 36 ).…”

Section: Casementioning

confidence: 99%

Retransplanting a previously transplanted kidney: A safe strategy in times of organ shortage?

Karakizlis

Rosmalen

Boide

et al. 2021

Clinical Transplantation

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Background:The shortage of organs for transplantation remains a global problem. The retransplantation of a previously transplanted kidney might be a possibility to expand the pool of donors. We provide our experience with the successful reuse of transplanted kidneys in the Eurotransplant region.Methods: A query in the Eurotransplant database was performed between January 1, 1995 and December 31, 2015, to find kidney donors who themselves had previously received a kidney graft.Results: Nine out of a total of 68,554 allocated kidneys had previously been transplanted. Four of these kidneys were transplanted once again. The mean interval between the first transplant and retransplantation was 1689±1682 days (SD; range 55-5,333 days). At the time of the first transplantation the mean serum creatinine of the donors was 1.0 mg/dl (.6-1.3 mg/dl) and at the second transplantation 1.4 mg/dl (.8-1.5 mg/dl). The mean graft survival in the first recipient was 50 months (2-110 months) and in the second recipient 111 months (40-215 months). Conclusion:Transplantation of a previously transplanted kidney may successfully be performed with well-preserved graft function and long-term graft survival, even if the first transplantation was performed a long time ago. Such organs should be considered even for younger recipients in carefully selected cases.

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Section: Casementioning

confidence: 99%

Retransplanting a previously transplanted kidney: A safe strategy in times of organ shortage?

Karakizlis

Rosmalen

Boide

et al. 2021

Clinical Transplantation

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Evaluation of Expanded Criteria Donors Using the Kidney Donor Profile Index and the Preimplantation Renal Biopsy

Villanego¹,

Vigara²,

Cazorla³

et al. 2022

Transpl Int

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The increasing comorbidity of kidney transplant (KT) donors make it necessary to develop scores to correctly assess the quality of kidney grafts. This study analyzes the usefulness of the preimplantation biopsy and the Kidney Donor Profile Index (KDPI) as indicators of KT survival from expanded criteria donors (ECD). Retrospective study of KT in our center between January 2010 to June 2019 who received a kidney from an ECD and underwent a preimplantation biopsy. 266 KT were included. Graft survival was categorized by KDPI quartiles: Q1 = 86%, Q2 = 95%, Q3 = 99% and Q4 = 100%. KT from KDPI Q1 presented better survival (p = 0.003) and Q4 donors had worse renal function (p = 0.018) and poorer glomerular filtration rate (3rd month; p = 0.017, 1st year; p = 0.010). KT survival was analyzed according to KDPI quartile and preimplantation biopsy score simultaneously: Q1 donors with biopsy score ≤3 had the best survival, especially comparing against Q3 with a biopsy score >3 and Q4 donors (p = 0.014). In multivariable analysis, hyaline arteriopathy, glomerulosclerosis, and KDPI Q4 were predictors for graft survival. High KDPI and a greater histological injury in the preimplantation biopsy, especially glomerular and vascular lesions, were related to a higher rate of KT loss from ECD.

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Pretransplant Biopsy of Marginal Kidneys: Is It Necessary?

Cited by 2 publications

References 14 publications

Retransplanting a previously transplanted kidney: A safe strategy in times of organ shortage?

Retransplanting a previously transplanted kidney: A safe strategy in times of organ shortage?

Evaluation of Expanded Criteria Donors Using the Kidney Donor Profile Index and the Preimplantation Renal Biopsy

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