Histopathologic evaluation of pretransplantation biopsy as a factor inﬂuencing graft function after kidney transplantation in 3-year observation
T Sulikowski, K Tejchman, L Domański, Z Ziętek, M Romanowski, E Urasińska, K Safranow, M Kamiński, M Żukowski, A Ciechanowicz, K Ciechanowski, M Ostrowski
Ann Transplant 2009; 14(1): 48-48
Many factors affect long-term results in kidney transplantation including histological damage as an independent predictor. Histopathology findings correlate with the incidence of DGF, renal function and allograft survival. We analyzed 92 renal thick needle pre-implantation biopsies and 35 obtained from graft after explantation. Optimal biopsies contained at least 10 gromeruli and at least 2 cross-sections of arteries. In biopsies we analyzed: tubulitis, intensity of ATN, inï¬‚ammatory infiltration, glomerulonephritis, arterial hyalinization, arteritis, fibrosis, tubular atrophy, fibrosis of arterial intimae, increase of mesangial matrix, and percentage of glomerulosclerosis. In postoperative time we analyzed: patients condition, urine output, serum concentrations of creatinine, urea, uric acid and ions, necessity of postoperative dialysis. During 3-year observation we analyzed: living recipients, graft loss, death of a patient with functioning graft, incidence of CAN and AR. We found significant correlation between IGF and lack of ATN in pre-0 biopsy. We observed no correlation between renal function and: arterial hyalinization and fibrosis, inï¬‚ammatory infiltration, tubular atrophy. In postoperative time we observed significant correlation between IGF and lack of interstitial fibrosis with significant lower levels of creatinine, urea, potassium and higher urine output early after transplantation. IGF and better function of the good quality kidney was correlated with shorter time of reaching creatinine level 2mg%. In the postoperative time we also observed difference between renal function depending on the gender. The presence of acute tubular necrosis, arterial fibrosis, lack of inï¬‚ammatory infiltration in pre-0 biopsy was correlated with worse late renal function. In explantation biopsies signs of CAN - 73%, histological marks of AR - 39%.
Keywords: Kidney Transplantation