The presence of glomerular sclerosis at time zero has a significant impact on function after cadaveric renal transplantation

Xavier Escofet, Hisham Osman, David F. R. Griffiths, Suzanna Woydag, W. Adam Jurewicz
2003 Transplantation  
Introduction. The aim was to determine the impact of donor glomerulosclerosis on allograft outcome. Methods. The percentage of glomerular sclerosis (%GS) was calculated in protocol biopsies taken at engraftment. Clinical variables were obtained from the Welsh Transplantation Research Group (WTRG) database. Results. Of 210 allografts, 129 showed %GS‫,0؍‬ but 81 kidneys showed %GS between 1 and 60. Patients with %GS‫0؍‬ had the highest glomerular filtration rate (GFR) at 1 year (62.0 mL/min) and
more » ... he slowest deterioration of function (؊3.8 mL/min per year). Patients with %GS greater than 20 had the lowest GFR at 1 year (36.0 mL/min) and the steepest rate of deterioration (؊9.0 mL/min per year). The %GS of 10 alone can reduce GFR at 4 years by 8 mL/min, a similar reduction to a single rejection episode or an increase in donor age of 30 years. Actuarial 5-year graft survival for %GS‫0؍‬ was 80%, and for %GS greater than 20 was 35% (P‫.)40.0؍‬ Conclusion. The findings indicate that a biopsy taken at procurement will provide information for the most appropriate allocation of a kidney.
doi:10.1097/ pmid:12589156 fatcat:s2p6umky6zh4pl3jxygjs6robu