Current Topics in TransplantationRenal transplantationSignificance of Time-Zero Biopsy for Graft Renal Function After Deceased Donor Kidney Transplantation

•The majority of histological findings were associated with donor age.•Early graft renal function was significantly associated with donor age.•Early graft renal function was significantly associated with AH and CI.•Clinico-histological findings of deceased donors could predict early graft outcomes.

BackgroundDonor organ quality from deceased donors affects graft survival after kidney transplantation. This study was performed to identify clinico-histological factors that affect early graft outcome, using time-zero biopsies of deceased donors.MethodsBetween December 2006 and July 2011, 135 recipients of deceased donor kidneys were included, and data concerning donor and recipient-related clinical characteristics and histological findings of time-zero biopsies categorized by use of the Banff 07 scoring system were included in the analysis. Mean donor age was 44.3 ± 12.3 years. Mean terminal serum creatinine level and cold ischemic time were 1.50 ± 0.96 mg/dL and 349 ± 166 minutes. Mean follow-up time after transplantation was 37 ± 16 months, and all recipients were followed for at least 1 year.ResultsGlobal glomerulosclerosis (38.5%), tubular atrophy (37.8%), arteriolar hyaline thickening (25.9%), interstitial fibrosis (23%), vascular fibrous intimal thickening (21.5%), and interstitial inflammation (20%) were the major pathologic findings of time-zero biopsies. The majority of pathologic scores were of mild degree. Among histological findings, arteriolar hyaline thickening and interstitial fibrosis were only significantly associated with early post-transplant renal function in multivariate analyses.ConclusionsConsiderations of clinico-histological findings were found to be valuable for predicting early graft outcome after deceased donor kidney transplantation.