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- Title
Valor pronóstico de la biopsia renal preimplante en donantes fallecidos de edad avanzada en la función renal al an˜ o del trasplante.
- Authors
Amenábar, Juan J.; Camacho, Jhon A.; Gómez-Larrambe, Nerea; Visus, Teresa; Pijoan, José I.; González del Tánago, Jaime; Zárraga, Sofía; García-Olaverri, Jorge; Gaínza, Francisco J.
- Abstract
Background: Preimplantation renal biopsy provides potentially valuable information about post-transplant renal function. Objective: To assess the prognostic value of preimplantation kidney biopsy from older donors in determining 1-year post-transplant estimated glomerular filtration rate MDRD-4 (eGFR). Methods: We evaluated a cohort of 124 renal transplant recipients from deceased donors ≥60 years old, performed at our center between March 2008 and May 2012. Biopsies were assessed by applying the score proposed by O'Valle et al. The overall score was stratified into 3 levels: 0-3, 4-5 and 6-8 points. Kidneys scoring > 8 points were discarded. A total of 77% of the donors were ≥70 years. Results: One year post-transplant, mean eGFR (SD) was lower in transplant recipients with 6-8 points (38.5 [14.1] mL/min/1.73 m²) than in the group scoring 4-5 points (46.3 [15.7] [p = 0.03]) and the group scoring 0-3 (49.6 [12.5] [P=.04]). Seven patients (19%) had eGFR <30 mL/min/1.73 m² 1 year post-transplant in group 6-8 vs. 8 (14%) in group 4-5 and none in group 0-3. In the logistic regression, OR (95% IC), to determine patients with 1-year post-transplant eGFR (<30 mL/min/1.73 m²), delayed graft function (6.3 [1.9-21.3]) and acute rejection (5.8 [1.1-31]), were significant. The adjusted OR of biopsy score group 6-8 vs. 0-5, was 2.2 (0.7-7.3). Conclusions: Allografts with higher pathologic score in preimplantation renal biopsy were associated with a worse 1-year post-transplant eGFR. Delayed graft function and acute rejection were significant risk factors for 1-year post-transplant low eGFR.
- Publication
Nefrologia, 2016, Vol 36, Issue 1, p33
- ISSN
0211-6995
- Publication type
Article
- DOI
10.1016/j.nefro.2015.10.009