TY - JOUR
T1 - Only IF/TA in the Histological Evaluation of Post-Reperfusion Baseline Biopsies Correlates With Kidney Transplant Outcome
AU - Bachmann, Quirin
AU - Torrez, Carlos
AU - Büttner-Herold, Maike
AU - Haller, Bernhard
AU - Haberfellner, Flora
AU - Hausinger, Renate
AU - Assfalg, Volker
AU - Renders, Lutz
AU - Amann, Kerstin
AU - Heemann, Uwe
AU - Schmaderer, Christoph
AU - Kemmner, Stephan
N1 - Publisher Copyright:
Copyright © 2025 Bachmann, Torrez, Büttner-Herold, Haller, Haberfellner, Hausinger, Assfalg, Renders, Amann, Heemann, Schmaderer and Kemmner.
PY - 2024
Y1 - 2024
N2 - Here, we retrospectively evaluated the informational yield of 338 post-reperfusion kidney transplant biopsies (including 95 living donations) assessed according to BANFF for the histological characteristics interstitial fibrosis and tubular atrophy (IF/TA), glomerulosclerosis, arteriosclerosis, and acute tubular injury (ATI). Associations with delayed graft function (DGF) and death-censored graft survival were explored through Cox-regression analyses. The maximum follow-up time was 11.4 years, with DGF observed in 108 (32%) cases. After deceased donation there was no association between DGF and histologic parameters. Univariable Cox-regression unveiled an association of IF/TA and glomerulosclerosis with long-term death-censored graft survival (HR per 10% increase: IF/TA 1.63; 95% CI 1.17–2.28; p = 0.003; glomerulosclerosis 1.19; 95% CI 1.01–1.39; p = 0.031). In multivariable Cox regression analyses, adjusted for recognized clinical risk variables like expanded criteria donor-status, donor age, history of diabetes, and HLA-mismatches, only IF/TA maintained association over the total observation period in deceased donations and in the total cohort. Arteriosclerosis and ATI were not associated with clinical outcome after deceased donation. Especially ATI did not affect delayed graft function if only deceased donations were considered. Our data underlines the role of organ quality for transplant outcome prior to acute lesions such as ATI during the transplantation process.
AB - Here, we retrospectively evaluated the informational yield of 338 post-reperfusion kidney transplant biopsies (including 95 living donations) assessed according to BANFF for the histological characteristics interstitial fibrosis and tubular atrophy (IF/TA), glomerulosclerosis, arteriosclerosis, and acute tubular injury (ATI). Associations with delayed graft function (DGF) and death-censored graft survival were explored through Cox-regression analyses. The maximum follow-up time was 11.4 years, with DGF observed in 108 (32%) cases. After deceased donation there was no association between DGF and histologic parameters. Univariable Cox-regression unveiled an association of IF/TA and glomerulosclerosis with long-term death-censored graft survival (HR per 10% increase: IF/TA 1.63; 95% CI 1.17–2.28; p = 0.003; glomerulosclerosis 1.19; 95% CI 1.01–1.39; p = 0.031). In multivariable Cox regression analyses, adjusted for recognized clinical risk variables like expanded criteria donor-status, donor age, history of diabetes, and HLA-mismatches, only IF/TA maintained association over the total observation period in deceased donations and in the total cohort. Arteriosclerosis and ATI were not associated with clinical outcome after deceased donation. Especially ATI did not affect delayed graft function if only deceased donations were considered. Our data underlines the role of organ quality for transplant outcome prior to acute lesions such as ATI during the transplantation process.
KW - acute tubular injury
KW - arteriosclerosis
KW - delayed graft function
KW - donor quality
KW - glomerulosclerosis
KW - interstitial fibrosis and tubular atrophy
KW - ischemia-reperfusion injury
KW - kidney transplantation
UR - http://www.scopus.com/inward/record.url?scp=85214969206&partnerID=8YFLogxK
U2 - 10.3389/ti.2024.13646
DO - 10.3389/ti.2024.13646
M3 - Article
AN - SCOPUS:85214969206
SN - 0934-0874
VL - 37
JO - Transplant International
JF - Transplant International
M1 - 13646
ER -