Effect of chronic lesions in implantation biopsy on the function and survival of renal grafts from cardiac death donors

Abstract

Objective To explore the effect of chronic lesions in implantation biopsy on the function and survival of renal grafts from donation after cardiac death (DCD) donors. Methods Preimplant kidney biopsy from DCD donors from July 2011 to December 2014 was retrospectively reviewed. There were 71 cases of DCD donors including 14 cases of China Category Ⅱ and 57 cases of China Category Ⅲ. The causes of death were brain trauma (n=25), cerebrovascular accident (n=38), brain tumor (n=2), and anoxia (n=6). The rate of glomorulosclerosis (GS) and Remuzzi score of the kidneys were calculated and the effects of GS and Remuzzi score on the renal graft function and survival time were evaluated. Results Needle biopsies were performed on 41 cases with glomeruli 23.7±9.6 (2 strips), and wedge biopsies were performed on 30 cases with glomeruli 37.2±16.7. The 12-month estimated glomerular filtration rate (eGFR) of renal grafts with GS 0-20% was significantly higher than grafts with GS>20% (72.9±22.6 mL/min vs. 48.9±18.9 mL/min, P 20%, and between kidneys with Remuzzi score 0-3 and 4-5. Conclusion Kidneys from DCD donors with severe chronic lesions (GS >20% or Remuzzi score 4-5) have poor graft function at one year after transplantation but with excellent short-term graft survival. Key words: Kidney transplantation; Donor; Kidney; Biopsy; Graft survival