Kidneys retrieved from donors after cardiac death (DCD) pose significant challenges from a clinical and technical point of view, undergoing a variable degree of ischemia-reperfusion injury. At present, the utilization of kidneys is assessed according to the Karpinski score, which does not take into account the ischemic insult and does not predict the functional recovery of the organ once transplanted. Therefore, the correlation between biopsy results and post-transplant graft function is still debated. In this study we examined kidney biopsies from DCD donors; we calculated the Karpinski score and subsequently identified and quantified the ischemic lesions in the glomerular, interstitial, and tubular compartments. These same lesions were quantified in kidney biopsies from donors after brain death (DBD) in a case-control analysis. The collected data were correlated with the clinical data of the donors and the post-transplant follow-up. Proximal tubule alterations are crucial in ischemia-reperfusion damage, showing precise histological alterations, which are more frequent in DCD than in DBD donors and are statistically correlated with functional recovery of the organ. Quantification of ischemic tubular lesions in biopsies of kidneys from DCD donors is a useful tool for predicting post-transplant renal function and a valid parameter for assessing the quality of the graft.

Histological evaluation of ischemic alterations in donors after cardiac death: A useful tool to predict post-transplant renal function / M. Zagni, G.A. Croci, A. Cannavò, S.M. Passamonti, T. De Feo, F.L. Boggio, F.M. Cribiù, M. Maggioni, S. Ferrero, A. Del Gobbo, U. Gianelli. - In: CLINICAL TRANSPLANTATION. - ISSN 0902-0063. - (2022). [Epub ahead of print] [10.1111/ctr.14622]

Histological evaluation of ischemic alterations in donors after cardiac death: A useful tool to predict post-transplant renal function

M. Zagni
Primo
;
G.A. Croci
Secondo
;
S.M. Passamonti;T. De Feo;F.L. Boggio;S. Ferrero;A. Del Gobbo
Penultimo
;
U. Gianelli
Ultimo
2022

Abstract

Kidneys retrieved from donors after cardiac death (DCD) pose significant challenges from a clinical and technical point of view, undergoing a variable degree of ischemia-reperfusion injury. At present, the utilization of kidneys is assessed according to the Karpinski score, which does not take into account the ischemic insult and does not predict the functional recovery of the organ once transplanted. Therefore, the correlation between biopsy results and post-transplant graft function is still debated. In this study we examined kidney biopsies from DCD donors; we calculated the Karpinski score and subsequently identified and quantified the ischemic lesions in the glomerular, interstitial, and tubular compartments. These same lesions were quantified in kidney biopsies from donors after brain death (DBD) in a case-control analysis. The collected data were correlated with the clinical data of the donors and the post-transplant follow-up. Proximal tubule alterations are crucial in ischemia-reperfusion damage, showing precise histological alterations, which are more frequent in DCD than in DBD donors and are statistically correlated with functional recovery of the organ. Quantification of ischemic tubular lesions in biopsies of kidneys from DCD donors is a useful tool for predicting post-transplant renal function and a valid parameter for assessing the quality of the graft.
biomarker, biopsy, delayed graft function (DGF), donors and donation: donation after circulatory death (DCD), kidney failure; injury; Brain Death; Death; Delayed Graft Function; Graft Survival; Humans; Ischemia; Kidney; Retrospective Studies; Tissue Donors; Kidney Transplantation; Tissue and Organ Procurement
Settore MED/08 - Anatomia Patologica
24-feb-2022
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/929207
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