Pre-existing arteriosclerotic intimal thickening in living-donor kidneys reflects allograft function

Tadashi Sofue, Masashi Inui, Hideyasu Kiyomoto, Masahiro Moritoki, Satoshi Nishioka, Yoko Nishijima, Kumiko Moriwaki, Taiga Hara, Yoshio Kushida, Reiji Haba, Takeshi Yoda, Tomohiro Hirao, Yoshiyuki Kakehi, Akira Nishiyama, Masakazu Kohno

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)

Abstract

Background: Donor shortage is a serious problem worldwide and it is now debated whether kidneys from marginal donors are suitable for renal transplantation. Recent studies have shown that the findings of preimplantation kidney biopsy are useful to evaluate vasculopathy in the donated kidney, and may predict transplant outcomes in deceased- donor kidney transplantation. However, few studies have focused on the pathological findings of preimplantation biopsy in living-donor kidney transplantation. Therefore, we investigated whether arteriosclerotic vasculopathy in living-donor kidneys at the time of transplantation predicts the recipient's kidney function (allograft function) later in life. Methods: We retrospectively analyzed 75 consecutive adult living-donor kidney transplants performed at Kagawa University Hospital. Renal arteriosclerotic vasculopathy was defined according to the presence of fibrous intimal thickening in the interlobular artery. Results: Forty-one kidneys exhibited mild arteriosclerotic vasculopathy on preimplantation kidney biopsies. The decreases in estimated glomerular filtration rate after donation were similar in donors with or without renal arteriosclerotic vasculopathy. Pre-existing arteriosclerotic vasculopathy did not affect graft survival rate, patient survival rate or the incidence of complications. Recipients of kidneys with arteriosclerotic vasculopathy had lower allograft function at 1 and 3 years after transplantation than the recipients of arteriosclerosis-free kidneys with or without donor hypertension. In multivariate analysis, fibrous intimal thickening on preimplantation biopsy was predictive of reduced allograft function at 1 year after transplantation. Conclusions: The present study demonstrated that mild arteriosclerotic vasculopathy in the donated kidney is an important pathological factor that reflects future impaired function of renal allografts from marginal donors.

Original languageEnglish
Pages (from-to)127-135
Number of pages9
JournalAmerican Journal of Nephrology
Volume36
Issue number2
DOIs
Publication statusPublished - 2012 Aug

Keywords

  • Arteriosclerotic intimal thickening
  • Living-donor kidney transplantation
  • Marginal donors
  • Preimplantation kidney biopsy

ASJC Scopus subject areas

  • Nephrology

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