Kidney Structural Features from Living Donors Predict Graft Failure in Recipients
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,
findings provide insights into a graftâ€™s â€˜intrinsic qualityâ€™ 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.