Kidney Structural Features from Living Donors Predict Graft Failure in Recipients
This information, I would like to pass on to those who are actively involved in Renal Transplant. This appears to be a recent concept and may have its utility in predicting Graft Failures who have live Donor Transplant.
The team led by Andrew D Rule ( 2020 Published online Jan 20th) found that subclinical Structural features at the time of Kidney Donation modestly contribute to Graft failure which is independent of Living Donor and Recipient Clinical characteristics. In an analysis of 2293 kidney donor-recipient pairs, interstitial fibrosis/tubular atrophy (IF/TA), arteriolar hyalinosis, and nephron enlargement in the intraoperative biopsy specimens independently predicted graft failure. IF/TA exceeding 5% (vs 0%), arteriolar hyalinosis, and larger tubular area were associated with 4.5-, 1.6-, and 1.2-fold increased risks for death-censored graft failure, respectively. These findings provide insights into a graft’s ‘intrinsic quality’ at the time of donation, and further support the use of intraoperative biopsies to identify kidney grafts that are at higher risk for failure. They further postulated that these patients may benefit from non-Calcineurin-inhibitor-based Immunosuppression or more aggressive management of blood pressure.
With warm regards,