Only IF/TA in the Histological Evaluation of Post-Reperfusion Baseline Biopsies Correlates With Kidney Transplant Outcome
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...
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Frontiers Media S.A.
2025-01-01
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Online Access: | https://www.frontierspartnerships.org/articles/10.3389/ti.2024.13646/full |
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author | Quirin Bachmann Carlos Torrez Maike Büttner-Herold Bernhard Haller Flora Haberfellner Renate Hausinger Volker Assfalg Lutz Renders Kerstin Amann Uwe Heemann Christoph Schmaderer Stephan Kemmner Stephan Kemmner |
author_facet | Quirin Bachmann Carlos Torrez Maike Büttner-Herold Bernhard Haller Flora Haberfellner Renate Hausinger Volker Assfalg Lutz Renders Kerstin Amann Uwe Heemann Christoph Schmaderer Stephan Kemmner Stephan Kemmner |
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description | 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. |
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institution | Kabale University |
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language | English |
publishDate | 2025-01-01 |
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spelling | doaj-art-c8fd451b4f68428187688ee2a39989252025-01-03T04:12:41ZengFrontiers Media S.A.Transplant International1432-22772025-01-013710.3389/ti.2024.1364613646Only IF/TA in the Histological Evaluation of Post-Reperfusion Baseline Biopsies Correlates With Kidney Transplant OutcomeQuirin Bachmann0Carlos Torrez1Maike Büttner-Herold2Bernhard Haller3Flora Haberfellner4Renate Hausinger5Volker Assfalg6Lutz Renders7Kerstin Amann8Uwe Heemann9Christoph Schmaderer10Stephan Kemmner11Stephan Kemmner12Department of Nephrology, University Hospital Rechts der Isar, Technical University of Munich, TUM School of Medicine and Health, Munich, GermanyDepartment of Nephrology, University Hospital Rechts der Isar, Technical University of Munich, TUM School of Medicine and Health, Munich, GermanyDepartment of Nephropathology, Institute of Pathology, Friedrich-Alexander-University Erlangen-Nuremberg (FAU) and University Hospital, Erlangen, GermanyInstitute of AI and Informatics in Medicine, University Hospital Rechts der Isar, Technical University of Munich, TUM School of Medicine and Health, Munich, GermanyDepartment of Nephrology, University Hospital Rechts der Isar, Technical University of Munich, TUM School of Medicine and Health, Munich, GermanyDepartment of Nephrology, University Hospital Rechts der Isar, Technical University of Munich, TUM School of Medicine and Health, Munich, GermanyDepartment of Surgery, University Hospital Rechts der Isar, Technical University of Munich, TUM School of Medicine and Health, Munich, GermanyDepartment of Nephrology, University Hospital Rechts der Isar, Technical University of Munich, TUM School of Medicine and Health, Munich, GermanyDepartment of Nephropathology, Institute of Pathology, Friedrich-Alexander-University Erlangen-Nuremberg (FAU) and University Hospital, Erlangen, GermanyDepartment of Nephrology, University Hospital Rechts der Isar, Technical University of Munich, TUM School of Medicine and Health, Munich, GermanyDepartment of Nephrology, University Hospital Rechts der Isar, Technical University of Munich, TUM School of Medicine and Health, Munich, GermanyDepartment of Nephrology, University Hospital Rechts der Isar, Technical University of Munich, TUM School of Medicine and Health, Munich, GermanyTransplant Center, University Hospital Munich, Ludwig-Maximilians-University (LMU), Munich, GermanyHere, 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.https://www.frontierspartnerships.org/articles/10.3389/ti.2024.13646/fullkidney transplantationischemia-reperfusion injurydelayed graft functiondonor qualityinterstitial fibrosis and tubular atrophyglomerulosclerosis |
spellingShingle | Quirin Bachmann Carlos Torrez Maike Büttner-Herold Bernhard Haller Flora Haberfellner Renate Hausinger Volker Assfalg Lutz Renders Kerstin Amann Uwe Heemann Christoph Schmaderer Stephan Kemmner Stephan Kemmner Only IF/TA in the Histological Evaluation of Post-Reperfusion Baseline Biopsies Correlates With Kidney Transplant Outcome Transplant International kidney transplantation ischemia-reperfusion injury delayed graft function donor quality interstitial fibrosis and tubular atrophy glomerulosclerosis |
title | Only IF/TA in the Histological Evaluation of Post-Reperfusion Baseline Biopsies Correlates With Kidney Transplant Outcome |
title_full | Only IF/TA in the Histological Evaluation of Post-Reperfusion Baseline Biopsies Correlates With Kidney Transplant Outcome |
title_fullStr | Only IF/TA in the Histological Evaluation of Post-Reperfusion Baseline Biopsies Correlates With Kidney Transplant Outcome |
title_full_unstemmed | Only IF/TA in the Histological Evaluation of Post-Reperfusion Baseline Biopsies Correlates With Kidney Transplant Outcome |
title_short | Only IF/TA in the Histological Evaluation of Post-Reperfusion Baseline Biopsies Correlates With Kidney Transplant Outcome |
title_sort | only if ta in the histological evaluation of post reperfusion baseline biopsies correlates with kidney transplant outcome |
topic | kidney transplantation ischemia-reperfusion injury delayed graft function donor quality interstitial fibrosis and tubular atrophy glomerulosclerosis |
url | https://www.frontierspartnerships.org/articles/10.3389/ti.2024.13646/full |
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