INTRODUCTION: The aim was to determine the impact of donor glomerulosclerosis on allograft outcome. METHODS: The percentage of glomerular sclerosis (%GS) was calculated in protocol biopsies taken at engraftment. Clinical variables were obtained from the Welsh Transplantation Research Group (WTRG) database. RESULTS: Of 210 allografts, 129 showed %GS=0, but 81 kidneys showed %GS between 1 and 60. Patients with %GS=0 had the highest glomerular filtration rate (GFR) at 1 year (62.0 mL/min) and the slowest deterioration of function (-3.8 mL/min per year). Patients with %GS greater than 20 had the lowest GFR at 1 year (36.0 mL/min) and the steepest rate of deterioration (-9.0 mL/min per year). The %GS of 10 alone can reduce GFR at 4 years by 8 mL/min, a similar reduction to a single rejection episode or an increase in donor age of 30 years. Actuarial 5-year graft survival for %GS=0 was 80%, and for %GS greater than 20 was 35% ( P=0.04). CONCLUSION: The findings indicate that a biopsy taken at procurement will provide information for the most appropriate allocation of a kidney.
INTRODUCTION: The aim was to determine the impact of donorglomerulosclerosis on allograft outcome. METHODS: The percentage of glomerular sclerosis (%GS) was calculated in protocol biopsies taken at engraftment. Clinical variables were obtained from the Welsh Transplantation Research Group (WTRG) database. RESULTS: Of 210 allografts, 129 showed %GS=0, but 81 kidneys showed %GS between 1 and 60. Patients with %GS=0 had the highest glomerular filtration rate (GFR) at 1 year (62.0 mL/min) and the slowest deterioration of function (-3.8 mL/min per year). Patients with %GS greater than 20 had the lowest GFR at 1 year (36.0 mL/min) and the steepest rate of deterioration (-9.0 mL/min per year). The %GS of 10 alone can reduce GFR at 4 years by 8 mL/min, a similar reduction to a single rejection episode or an increase in donor age of 30 years. Actuarial 5-year graft survival for %GS=0 was 80%, and for %GS greater than 20 was 35% ( P=0.04). CONCLUSION: The findings indicate that a biopsy taken at procurement will provide information for the most appropriate allocation of a kidney.
Authors: Robert J Stratta; Michael S Rohr; Aimee K Sundberg; Alan C Farney; Erica L Hartmann; Phillip S Moore; Jeffrey Rogers; Samy S Iskandar; Michael D Gautreaux; David F Kiger; William Doares; Teresa K Anderson; Gloria Hairston; Patricia L Adams Journal: Ann Surg Date: 2006-05 Impact factor: 12.969
Authors: María José Pérez-Sáez; Núria Montero; Dolores Redondo-Pachón; Marta Crespo; Julio Pascual Journal: Transplantation Date: 2017-04 Impact factor: 4.939
Authors: Robert J Stratta; Michael S Rohr; Aimee K Sundberg; Greg Armstrong; Gloria Hairston; Erica Hartmann; Alan C Farney; Julie Roskopf; Samy S Iskandar; Patricia L Adams Journal: Ann Surg Date: 2004-05 Impact factor: 12.969
Authors: Bertram L Kasiske; Darren E Stewart; Bipin R Bista; Nicholas Salkowski; Jon J Snyder; Ajay K Israni; Gretchen S Crary; John D Rosendale; Arthur J Matas; Francis L Delmonico Journal: Clin J Am Soc Nephrol Date: 2014-02-20 Impact factor: 8.237