PMID- 10751050
OWN - NLM
STAT- MEDLINE
DCOM- 20000605
LR  - 20220408
IS  - 0902-0063 (Print)
IS  - 0902-0063 (Linking)
VI  - 13 Suppl 1
DP  - 1999
TI  - Histological factors of 1-h biopsy influencing the delayed renal function and 
      outcome in cadaveric renal allografts.
PG  - 6-12
AB  - The morphological characteristics of a kidney biopsy specimen taken 1 h after 
      reperfusion of blood into the graft (1-h biopsy) during a cadaveric transplant 
      operation were studied. The aim of the 1-h biopsy is to evaluate the 
      pre-transplant risk factors for the delayed graft function, assess the renal 
      function of the graft, and predict long-term graft survival. The total number of 
      1-h biopsies was 113, consisting of 86 male and 27 female donors. The mean age of 
      the donors is 39.5 +/- 17.3 yr. Arteriosclerosis (AS) and tubulo-interstitial 
      injury (TI) were both estimated using a semi-quantitative scale. AS score was 
      graded into four categories, according to the severity of the thickening of 
      interlobular artery: 0: none, 1: mild, 2: moderate and 3: severe. No biopsy 
      revealed severe AS of grade 3. The TI score was graded from 0 to 5, according to 
      the morphological injury: 0: none, 1-2 non-specific tubulo-interstitial injury 
      (NSTI), and 3-5 compatible with acute tubular necrosis (ATN) in terms of 
      pathological diagnosis. The mean ages of donors showing as AS of score 0, 1, and 
      2 were 30.6 +/- 14.6, 49.7 +/- 13.5, and 56.9 +/- 6.30, respectively. The mean 
      donor age of the AS 1 group and AS 2 group was significantly lower than for the 
      AS 0 group. The lowest serum creatinine values after operation (best Cr) of 
      recipients with AS scores of 0, 1, and 2 were 1.31 +/- 0.45, 1.60 +/- 0.70, and 
      1.84 +/- 0.71 mg/dL, respectively; the best Cr of AS scores of 1 and 2 was 
      significantly higher than in the AS score 0 group. The mean creatinine level at 
      the final point of the AS 0 group was significantly lower than in the combined AS 
      1 and AS 2 group (serum creatinine 1.44 +/- 1.03 vs 1.87 +/- 1.53 mg/dL: p < 
      0.01). The duration of severe hypotension less than 50 mmHg or 80 mmHg was 
      significantly shorter in the NSTI group than in the ATN group (less than 50 mmHg 
      was 29.7 +/- 124 vs 72.5 +/- 174, less than 80 mmHg 105 +/- 234 vs 193 +/- 261 
      min: p < 0.01). The post-operative (po) day expressing diuresis in excess of 1000 
      mL of urine per d was 8.28 +/- 17.5 and 13.7 +/- 23.3 (p < 0.01) in the NSTI and 
      ATN group, respectively. The po-d of the last hemodialysis and the po-d showing 
      serum creatinine less than 2.0 mg/dL in NSTI and ATN group was 7.74 +/- 17.4 and 
      13.3 +/- 23.2 (p < 0.01), and 25.0 +/- 30.5 and 38.0 +/- 35.2 (p < 0.01), 
      respectively. We concluded that 1-h renal biopsy is useful for assessing the 
      outcome of renal allograft. AS of a donor kidney is one of the most important 
      risk factors for both short and long-term outcome of the graft. The TI score was 
      useful to predict the outcome of delayed graft function.
FAU - Oda, A
AU  - Oda A
AD  - Internal Medicine, Biyoh Municipal Hospital, Ama-gun, Aichi, Japan.
FAU - Morozumi, K
AU  - Morozumi K
FAU - Uchida, K
AU  - Uchida K
LA  - eng
PT  - Journal Article
PL  - Denmark
TA  - Clin Transplant
JT  - Clinical transplantation
JID - 8710240
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Adult
MH  - Arteriosclerosis/pathology
MH  - Biopsy
MH  - Cadaver
MH  - Creatinine/blood
MH  - Female
MH  - Graft Rejection
MH  - Humans
MH  - Incidence
MH  - Kidney Transplantation/*pathology/*physiology
MH  - Kidney Tubular Necrosis, Acute/pathology
MH  - Male
MH  - Prognosis
MH  - Risk Factors
MH  - Time Factors
EDAT- 2000/04/06 09:00
MHDA- 2000/06/10 09:00
CRDT- 2000/04/06 09:00
PHST- 2000/04/06 09:00 [pubmed]
PHST- 2000/06/10 09:00 [medline]
PHST- 2000/04/06 09:00 [entrez]
PST - ppublish
SO  - Clin Transplant. 1999;13 Suppl 1:6-12.