Friday, 13 June 2014 09:03

The reproducibility and predictive value on outcome of renal biopsies from expanded criteria donors

By  Kidney International
Rate this item
(0 votes)

 

Reproducibility and predictive value on outcome are the main criteria to evaluate the utility of histological scores. Here we analyze the reproducibility of donor biopsy assessment by different on-call pathologists and the retrospective evaluation by a single renal pathologist blinded to clinical outcomes. We also evaluate the predictive value on graft outcome of both evaluations. A biopsy was performed in donors with any of the following: age greater than or equal to55 years, hypertension, diabetes, creatinine >1.5 mg/dl, or stroke. Glomerulosclerosis, interstitial fibrosis, tubular atrophy, intimal thickening, and arteriolar hyalinosis evaluated according to the Banff criteria were added to obtain a chronic score.

Biopsies were classified as mild (greater than or equal to3), intermediate (4–5), or advanced (6–7) damage, and unacceptable (greater than or equal to8) for transplantation of 127 kidneys biopsied. Weighted κ value between both readings was 0.41 (95% CI: 0.28–0.54). Evaluation of biopsies by the renal pathologist was significantly and independently associated with estimated 12-month glomerular filtration rate and a significant composite outcome variable, including death-censored graft survival and time to reach an estimated glomerular filtration rate <30 ml/min per 1.73 m2. Thus, there was no association between readings of on-call pathologists and outcome. The lack of association between histological scores obtained by the on-call pathologists and graft outcome suggests that a specific training on renal pathology is recommended to optimize the use of kidneys retrieved from expanded criteria donors.

 

 Authors:M Antonieta Azancot, Francesc Moreso, Maite Salcedo, Carme Cantarell, Manel Perello, Irina B Torres, Angeles Montero, Enric Trilla, Joana SellarÈs, Joan Morote and Daniel Seron

Reference: Kidney Int 85: 1161-1168; advance online publication, November 27, 2013; doi:10.1038/ki.2013.461

Additional Info

  • Language: English
  • Contains Audio: No
  • Content Type: Articles
  • Source: KI
  • Year: 2014
  • Members Only: No
Read 2262 times Last modified on Monday, 16 January 2017 06:35

Global Operations Center

Avenue des Arts 1-2
1210 Brussels, Belgium
Tel: +32 2 808 04 20
Fax: +32 2 808 4454
Email contact

               

Americas Operations Center

340 North Avenue 3rd Floor
Cranford, NJ 07016-2496, United States
Tel: +1 567 248 9703
Fax: +1 908 272 7101
Email contact