Correlation of Chronic Histologic Changes on Preimplantation Frozen Section Biopsy With Transplant Outcomes After Deceased Donor Kidney Transplantation

Jacob Ninan, Maxwell L. Smith, Amit K. Mathur, Jack W. Harbell, Caroline C. Jadlowiec, Sumi Sukumaran Nair, Adyr Moss, Kunam S. Reddy, Raymond Lackner Heilman

Research output: Contribution to journalArticlepeer-review

Abstract

Context.—It is unclear if preimplantation frozen section biopsy correlates with outcomes after deceased donor kidney transplantation. Objective.—To assess if chronic histologic changes on the preimplant frozen section correlates with graft loss and estimated glomerular filtration rate independently of kidney donor profile index (KDPI). Design.—Seven hundred three preimplantation biopsies were reviewed and a Banff sum score was calculated using glomerular sclerosis, interstitial fibrosis, vascular intimal thickening, and arteriolar hyalinosis. The posttransplant outcomes were compared for preimplantation biopsy Banff sum 0-1, 2-3, and 4-9. The cohort was also stratified by KDPI 85 or less versus more than 85. Results.—For the entire biopsy cohort, graft survival, estimated glomerular filtration rate at 1 year, and chronic changes on a 1-year posttransplant biopsy were superior in the group with preimplantation Banff sum 0-1. After stratifying by KDPI, the Banff sum no longer correlated with graft survival. In a univariate mode, using the Banff sum score as a continuous variable, a higher Banff sum score was significantly associated with graft failure (P ¼ .03); however, after adjusting the KDPI, the Banff sum score no longer correlated with graft failure (P ¼ .45). The 1-year estimated glomerular filtration rate and 1-year biopsy changes were superior in the group with Banff sum 0-1 only in the cohort with KDPI 85 or less. Conclusions.—In donor kidneys used for transplant, preimplantation biopsy chronic changes correlate with estimated glomerular filtration rate and biopsy findings at 1 year, but biopsies with mostly mild chronicity and Banff sum scores less than or equal to 5 did not impact graft survival beyond KDPI.

Original languageEnglish (US)
Pages (from-to)205-212
Number of pages8
JournalArchives of Pathology and Laboratory Medicine
Volume146
Issue number2
DOIs
StatePublished - Feb 2022

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

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