Reproducibility of Deceased Donor Kidney Procurement Biopsies.
allografts
atrophy
biopsy
cohort studies
confidence intervals
deceased donor kidney
humans
kidney
kidney biopsy
kidney transplantation
probability
procurement
reproducibility of results
sclerosis
tissue and organ procurement
tissue donors
transplant pathology
vascular diseases
Journal
Clinical journal of the American Society of Nephrology : CJASN
ISSN: 1555-905X
Titre abrégé: Clin J Am Soc Nephrol
Pays: United States
ID NLM: 101271570
Informations de publication
Date de publication:
07 02 2020
07 02 2020
Historique:
received:
06
08
2019
accepted:
05
12
2019
pubmed:
25
1
2020
medline:
1
6
2021
entrez:
25
1
2020
Statut:
ppublish
Résumé
Unfavorable histology on procurement biopsies is the most common reason for deceased donor kidney discard. We sought to assess the reproducibility of procurement biopsy findings. We compiled a continuous cohort of deceased donor kidneys transplanted at our institution from 1/1/2006 to 12/31/2016 that had at least one procurement biopsy performed, and excluded cases with missing biopsy reports and those used in multiorgan transplants. Suboptimal histology was defined as the presence of advanced sclerosis in greater than or equal to one biopsy compartment (glomeruli, tubules/interstitium, vessels). We calculated Of the 1011 kidneys included in our cohort, 606 (60%) had multiple procurement biopsies; 98% had first biopsy performed at another organ procurement organization and their second biopsy performed locally. Categorical agreement was highest for vascular disease ( Deceased donor kidneys that underwent multiple procurement biopsies often displayed substantial differences in histologic categorization in sequential biopsies, and there was no association between first biopsy findings and post-transplant outcomes.
Sections du résumé
BACKGROUND AND OBJECTIVES
Unfavorable histology on procurement biopsies is the most common reason for deceased donor kidney discard. We sought to assess the reproducibility of procurement biopsy findings.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS
We compiled a continuous cohort of deceased donor kidneys transplanted at our institution from 1/1/2006 to 12/31/2016 that had at least one procurement biopsy performed, and excluded cases with missing biopsy reports and those used in multiorgan transplants. Suboptimal histology was defined as the presence of advanced sclerosis in greater than or equal to one biopsy compartment (glomeruli, tubules/interstitium, vessels). We calculated
RESULTS
Of the 1011 kidneys included in our cohort, 606 (60%) had multiple procurement biopsies; 98% had first biopsy performed at another organ procurement organization and their second biopsy performed locally. Categorical agreement was highest for vascular disease (
CONCLUSIONS
Deceased donor kidneys that underwent multiple procurement biopsies often displayed substantial differences in histologic categorization in sequential biopsies, and there was no association between first biopsy findings and post-transplant outcomes.
Identifiants
pubmed: 31974289
pii: 01277230-202002000-00015
doi: 10.2215/CJN.09170819
pmc: PMC7015101
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
257-264Subventions
Organisme : NCATS NIH HHS
ID : KL2 TR001874
Pays : United States
Organisme : NCATS NIH HHS
ID : KL2 TR002539
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK116066
Pays : United States
Informations de copyright
Copyright © 2020 by the American Society of Nephrology.
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