MP79-07 USEFULNESS OF KIDNEY PREIMPLANTATION BIOPSIES FROM DECEASED DONORS FOR KIDNEY TRANSPLANT ALLOCATION

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery I1 Apr 2015MP79-07 USEFULNESS OF KIDNEY PREIMPLANTATION BIOPSIES FROM DECEASED DONORS FOR KIDNEY TRANSPLANT ALLOCATION David Lorente Garcia, Enrique Trilla Herrera, Cristian Isalt Lemonche, Lucas Regis Placido, Pol Servian Vives, Moreso Mateos Francesc, Daniel Seron Micas, Clara Garcia Carro, Maria Teresa Salcedo, and Juan Morote Robles David Lorente GarciaDavid Lorente Garcia More articles by this author , Enrique Trilla HerreraEnrique Trilla Herrera More articles by this author , Cristian Isalt LemoncheCristian Isalt Lemonche More articles by this author , Lucas Regis PlacidoLucas Regis Placido More articles by this author , Pol Servian VivesPol Servian Vives More articles by this author , Moreso Mateos FrancescMoreso Mateos Francesc More articles by this author , Daniel Seron MicasDaniel Seron Micas More articles by this author , Clara Garcia CarroClara Garcia Carro More articles by this author , Maria Teresa SalcedoMaria Teresa Salcedo More articles by this author , and Juan Morote RoblesJuan Morote Robles More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2864AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The number of discarded kidneys for transplantation approaches 25% in the Spanish transplant registry. The main cause(∼50%) is the presence of advanced histological lesions in kidney pre-implantation biopsies. Transplants results with expanded criteria donors are poorer than results with standard donors and kidneys with advanced histological lesions are not used in many transplant centers. AIM To analyze transplant results from deceased donors using pre-implantation biopsies to evaluate expanded donors in our renal transplant unit. METHODS Since 2009 all kidneys offered to our transplant unit were accepted for clinical examination. A pre-implantation kidney biopsy is obtained in patients with expanded criteria. Pre-implantation biopsies are processed in paraffin and pathologists cathegorizes the biopsies according to the Banff criteria (from 0 to 3). Individual scores are added and a pre-implantation score ranging from 0 to 15 is obtained. In general, kidneys with a pre-implantation donor score > 7 are discarded. An old-for-old policy is applied for kidney allocation with a donor/recipient age difference lower than 15 years. Kidneys with a donor biopsy score >5 were only transplanted in recipients older than 60 years RESULTS Between 2009 and 2013 we evaluated 404 kidneys and 41 (10%) were discarded. Only 20 kidneys (5%) were discarded due to a pre-implantation biopsy score >7. Thus, 362 transplants were performed and according to our protocol in 254 cases (70%) a pre-implantation biopsy was obtained. Donors with a pre-implantation biopsy were older (61±10 vs. 39±10 years, p<0.001) and have a lower estimated glomerular filtration rate (83±23 vs. 94±21 mL/min, p=0.006). Despite estimated GFR at 1 year was lower in transplants performed with donors with a pre-implantation biopsy (46±15 vs.59±18 mL/min, p<0.001), 5-year graft survival including death with function was not different between groups (83% vs. 77%). Transplant recipients from kidneys with advanced damage in the pre-implantation biopsy (score >5, n=79) have a similar renal function at 1 year (45±14 vs. 46±15 mL/min) and a similar 5-year graft survival (81.4% vs. 83.5%) than transplants from kidneys with lower scores (1 to 5). CONCLUSIONS Careful evaluation and selection of deceased donors and renal transplant recipients allows to reduce the number of discarded kidneys (10% in our unit) and to maintain standard transplant results. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1013 Peer Review Report Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Lorente Garcia More articles by this author Enrique Trilla Herrera More articles by this author Cristian Isalt Lemonche More articles by this author Lucas Regis Placido More articles by this author Pol Servian Vives More articles by this author Moreso Mateos Francesc More articles by this author Daniel Seron Micas More articles by this author Clara Garcia Carro More articles by this author Maria Teresa Salcedo More articles by this author Juan Morote Robles More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...