CONTEXT: Although risks associated with live kidney donation are low, there are few pathologic studies of kidneys from live donors, and possible risk factors for development of hypertension or renal insufficiency remain unknown. There are many studies of histopathologic changes in deceased donor kidneys and how these changes affect subsequent graft function; most are based on wedge rather than needle core biopsies. OBJECTIVE: To examine the frequency and severity of arterial fibrointimal thickening and other pathologic lesions in kidneys from healthy live donors and compare wedge and needle core biopsies as methods for evaluating these changes. DESIGN: For 36 of 332 live donor renal transplantations performed from January 2004 through November 2006, a wedge biopsy of the transplanted kidney was done prior to and/or after implantation, and a needle core biopsy was done postimplantation or during the ensuing 7 days. For these 36 allografts, we compared pathologic features of the wedge and core perioperative biopsies. RESULTS: Findings on core and wedge biopsies were similar, except for arterial fibrointimal thickening. Moderate thickening (Banff cv2) was present on 13 core biopsies, and mild thickening (cv1) was present on another 10; by contrast, no wedge biopsies showed cv2 lesions, and only 8 showed cv1. Arterial thickening on core but not wedge biopsies correlated significantly with increasing patient age. CONCLUSIONS: The findings indicate that needle core biopsies are superior to wedge biopsies for evaluating vascular changes in donor kidneys, and they suggest a need for studies correlating such changes with long-term outcomes of live donors, particularly older donors.
CONTEXT: Although risks associated with live kidney donation are low, there are few pathologic studies of kidneys from live donors, and possible risk factors for development of hypertension or renal insufficiency remain unknown. There are many studies of histopathologic changes in deceased donor kidneys and how these changes affect subsequent graft function; most are based on wedge rather than needle core biopsies. OBJECTIVE: To examine the frequency and severity of arterial fibrointimal thickening and other pathologic lesions in kidneys from healthy live donors and compare wedge and needle core biopsies as methods for evaluating these changes. DESIGN: For 36 of 332 live donor renal transplantations performed from January 2004 through November 2006, a wedge biopsy of the transplanted kidney was done prior to and/or after implantation, and a needle core biopsy was done postimplantation or during the ensuing 7 days. For these 36 allografts, we compared pathologic features of the wedge and core perioperative biopsies. RESULTS: Findings on core and wedge biopsies were similar, except for arterial fibrointimal thickening. Moderate thickening (Banff cv2) was present on 13 core biopsies, and mild thickening (cv1) was present on another 10; by contrast, no wedge biopsies showed cv2 lesions, and only 8 showed cv1. Arterial thickening on core but not wedge biopsies correlated significantly with increasing patient age. CONCLUSIONS: The findings indicate that needle core biopsies are superior to wedge biopsies for evaluating vascular changes in donor kidneys, and they suggest a need for studies correlating such changes with long-term outcomes of live donors, particularly older donors.
Authors: Mark Haas; Dorry L Segev; Lorraine C Racusen; Serena M Bagnasco; Jayme E Locke; Daniel S Warren; Christopher E Simpkins; Diane Lepley; Karen E King; Edward S Kraus; Robert A Montgomery Journal: J Am Soc Nephrol Date: 2008-09-05 Impact factor: 10.121
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
Authors: S M Kurian; E Velazquez; R Thompson; T Whisenant; S Rose; N Riley; F Harrison; T Gelbart; J J Friedewald; J Charette; S Brietigam; J Peysakhovich; M R First; M M Abecassis; D R Salomon Journal: Am J Transplant Date: 2017-04-03 Impact factor: 8.086
Authors: S Ali Husain; Kristen L King; Ibrahim Batal; Geoffrey K Dube; Isaac E Hall; Corey Brennan; M Barry Stokes; R John Crew; Dustin Carpenter; Hector Alvarado Verduzco; Raphael Rosen; Shana Coley; Eric Campenot; Dominick Santoriello; Adler Perotte; Karthik Natarajan; Vivette D D'Agati; David J Cohen; Lloyd E Ratner; Glen Markowitz; Sumit Mohan Journal: Clin J Am Soc Nephrol Date: 2020-01-23 Impact factor: 8.237
Authors: Sherry G Mansour; Isaac E Hall; Peter P Reese; Yaqi Jia; Heather Thiessen-Philbrook; Gilbert Moeckel; Francis L Weng; Monica P Revelo; Mazdak A Khalighi; Anshu Trivedi; Mona D Doshi; Bernd Schröppel; Chirag R Parikh Journal: Clin Transplant Date: 2018-12-06 Impact factor: 2.863
Authors: Dustin Carpenter; S Ali Husain; Corey Brennan; Ibrahim Batal; Isaac E Hall; Dominick Santoriello; Raphael Rosen; R John Crew; Eric Campenot; Geoffrey K Dube; Jai Radhakrishnan; M Barry Stokes; P Rodrigo Sandoval; Vivette D'Agati; David J Cohen; Lloyd E Ratner; Glen Markowitz; Sumit Mohan Journal: Clin J Am Soc Nephrol Date: 2018-10-25 Impact factor: 8.237