Relationship between pre-transplantation kidney biopsy andshort-term renal function after transplantation

Abstract

Objective To explore the correlation between pre-transplantation donor kidney biopsy and short-term renal function after transplantation. Methods This study include 240 kidney transplantation of donation after cardiac death (DCD) from July 2016 to April 2018. Banff's score of donor kidney biopsy was employed for estimating kidney status. Results No significant correlation existed between rate of glomerulosclerosis and delayed graft function (DGF) (P=0.815). The rate of glomerulosclerosis was significantly correlated with 1-week estimated glomerular filtration rate (eGFR) and discharge eGFR (P 0.05). Arterial fibrosis was significantly positively correlated with DGF and negatively with 1-week eGFR and discharge eGFR (P<0.05). Statistically significant inter-group differences existed in 1-week eGFR and discharge eGFR that arterial fibrosis scores < 2 (n=19) and ≥2 (n=41) (P<0.05). Arteriolar hyalinosis score was negatively correlated with 1-week eGFR and discharge eGFR (P<0.05). Based upon arteriolar hyalinosis scores, they were divided into two groups < 2 (n=193) and ≥2 (n=47). There were significant inter-group differences in DGF, 1-week eGFR and discharge eGFR (P<0.05). Remuzzi scores were negatively correlated with 1-week eGFR and discharge eGFR (P<0.05). Interstitial fibrosis was significantly positively correlated with DGF (P<0.05) and negatively with 1-week eGFR and discharge eGFR (P<0.05). Conclusions Donor kidney glomerulosclerosis rate affects short-term renal function of recipients after transplantation. However, using 20% as a threshold value is limited in clinical practice. Arterial intimal fibrosis and arteriolar hyalinosis are important factors affecting short-term eGFR. Recipient kidneys with Remuzzi score >4 had poor renal function after transplantation. Interstitial fibrosis score may be used as a predictor of postoperative DGF and short-term renal function recovery. It is expected to be discussed more extensively in literature. Key words: Kidney transplantation; Renal needle biopsy; Delayed renal graft function