Arteriolar hyalinization in implantation kidney biopsy as predictor of the graft function

Background: Many factors influence long-term function of transplanted kidney. Increasing number of evidences support the fact that histological assessment of implantation kidney biopsies can predict short- and long-term graft survival. Objective: Kidney function evaluation 2 years after transplantation depends on implantation chronic abnormalities present in donor's biopsy.
Material/Methods: Inclusion criteria: engraftment between 2006-2007 and serum creatinine concentration 1-2 mg/dl at 3 months after transplantation. By chronic abnormalities present in the donors' biopsy were understood arteriolar hyalinization (ah), interstitial fibrosis (ci), sclerotisation of the intimae (cv), tubular atrophy (ct), total inflammation (ti) and sclerotic glomeruli (Banff 2004). Graft function 2 years after engraftment was evaluated by eGFR C&G and serum creatinine concentration. Median observation time was 24.4 (15-32) months. Statistical analysis was performed using GLM Procedure of SAS System.
Results: Baseline transplant function (3 months after transplantation) was  similar in groups with and without chronic abnormalities. In the group with at least one abnormality in comparison to the group without abnormalities in biopsy (24 vs. 14) similar graft function after two years was found. However, graft function was significantly diminished in individuals with graft affected by arteriolar hyalinization (ah) compared to recipients free from ah (16 vs. 36) (mean eGFR values: 51.2±14.8 and 62.0±16.7, respectively - p <0.03, serum creatinine concentrations were 1.76±0.36 and 1.51±0.48 mg/dl, respectively - p<0.09).
Conclusions: The only predictor of graft function at 2 years was ah type abnormalities at implantation. This finding should be considered while choosing immunosuppressive regimen.

Keywords: Kidney Transplantation