Histological assessment of pre-transplant kidney biopsies is reproducible and representative

Histopathology
Maarten G J SnoeijsC J Peutz-Kootstra

Abstract

Histological examination of pre-transplant renal biopsy specimens can be used to select grafts from older donors after cardiac death (DCD) with a satisfactory transplant outcome. The aim was to determine whether such biopsy specimens can be reproducibly scored between pathologists and are representative of the whole kidney. In renal biopsy specimens from DCD aged >or=60 years (n = 44), globally sclerosed glomeruli, vascular narrowing, tubular atrophy and interstitial fibrosis were scored by three independent pathologists according to the Pirani scoring system. Interobserver agreement on the sum of scores improved considerably with the introduction of a combined tubulo-interstitial scoring system (intraclass correlation coefficient increased from 0.38 to 0.64). In small needle biopsy specimens (n = 144) obtained at autopsy, estimates of the proportion of globally sclerosed glomeruli were more precise with increasing sample size. Reasonably precise estimates may be obtained from specimens with at least seven glomeruli. It is feasible to implement pre-transplant renal biopsy specimen analysis as a selection criterion in clinical practice in order to accept kidneys from marginal donors for transplantation.

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Citations

Apr 12, 2012·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Zsuzsanna Bago-HorvathHeinz Regele
Feb 4, 2010·Current Opinion in Organ Transplantation·E R Pieter HooglandL W Ernest van Heurn
Mar 9, 2011·Current Opinion in Organ Transplantation·Ina Jochmans, Jacques Pirenne
Mar 16, 2013·Current Opinion in Organ Transplantation·Helmut Hopfer, Éva Kemény
Oct 29, 2015·Transplant International : Official Journal of the European Society for Organ Transplantation·Amaia SagastaManel Solé
Sep 21, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A SiedleckiD C Brennan
Mar 8, 2013·Clinical Transplantation·E R Pieter HooglandL W Ernest van Heurn
Jun 21, 2013·Transplant International : Official Journal of the European Society for Organ Transplantation·Elisa Sefora PierobonRigotti Paolo
Aug 12, 2014·Clinical Transplantation·E Lledó-GarcíaJ Pascual
Sep 5, 2015·Transplant International : Official Journal of the European Society for Organ Transplantation·L W Ernest van HeurnBenoit Barrou
Dec 17, 2014·Transplantation Proceedings·E Tavares da SilvaA Mota
Apr 12, 2012·Clinical Journal of the American Society of Nephrology : CJASN·Mariëlle A C J GelensMaarten H L Christiaans
Feb 25, 2021·Journal of the American Society of Nephrology : JASN·Brandon GinleyPinaki Sarder

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