Comparison between clinical and histopathological scoring in cadaveric kidney transplantation and its correlation with posttransplant evolution

Transplant Proc. 2006 Apr;38(3):903-4. doi: 10.1016/j.transproceed.2006.02.042.

Abstract

Introduction: There are several scoring systems, both clinical (Deceased Donor Score [DDS]) and histopathological (Remuzzi [REM]), that attempt to determine acceptability criteria for deceased donor kidney transplant. A retrospective study was performed among a group of kidney transplant recipients to evaluate posttransplant evolution with clinical and histopathological scores.

Materials and methods: Among 107 first deceased donor kidney transplant patients, 95 had undergone a pretransplant biopsy. Donor age was 38.46 +/- 16.9 years; recipient age: 49.2 +/- 16.3 years; DDS was 15.58 +/- 7.29. REM was 2.89 +/- 1.7. Delayed graft function was 64.2%. Induction therapy was administered to 49.5%. Cold ischemia time (CIT) was 1364 +/- 348 minute. Time on dialysis was 2275 +/- 1501 days. Induction therapy, immunosuppressive regimens, CIT, and time on dialysis were not significantly different among the groups. One-year patient and graft survival were 94.5% and 86%, respectively and 2-year values, 92.6% and 81%, respectively.

Conclusion: DDS showed a significant correlation with serum creatinine values over 1 and 2 years. REM did not show a significant association with any events. The differences were sustained after adjusting for other variables. Graft survival maintained a strong correlation with DDS categories and no association with REM. The clinical characteristics of a deceased donor appeared to be of greater importance than the biopsy findings in terms of posttransplant events.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Cadaver
  • Creatinine / blood
  • Graft Survival / physiology
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation / immunology
  • Kidney Transplantation / pathology*
  • Kidney Transplantation / physiology*
  • Middle Aged
  • Retrospective Studies
  • Tissue Donors
  • Treatment Outcome

Substances

  • Immunosuppressive Agents
  • Creatinine