Functional and Morphological Changes in Kidneys From Marginal Donors

Abstract Despite the increased number of cadaver donors and overall organ transplantations, we have observed a dramatic increase in the waiting list. We evaluated transplantations performed using marginal (n = 63) and “ideal” or optimal donors (n = 86). Donor and recipient functional and histopathol...

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Bibliographic Details
Published in:Transplantation proceedings 2012-09, Vol.44 (7), p.2139-2142
Main Authors: Borda, B, Szederkényi, E, Szenohradszky, P, Kemény, É, Marofka, F, Keresztes, C, Lázár, G
Format: Article
Language:English
Subjects:
Biological and medical sciences
Female
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Humans
Kidney - anatomy & histology
Kidney - physiology
Male
Medical sciences
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Tissue Donors
Tissue, organ and graft immunology
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Summary:Abstract Despite the increased number of cadaver donors and overall organ transplantations, we have observed a dramatic increase in the waiting list. We evaluated transplantations performed using marginal (n = 63) and “ideal” or optimal donors (n = 86). Donor and recipient functional and histopathological data were studied at 1 and 5 years after transplantation. Among the marginal donor group, we investigated whether the age or pre-existent hypertension in the donor showed a strong impact on the functional deterioration of the grafts. Twenty-three graftectomies were performed in marginal, and 39 in ideal recipients ( P = .002). Evaluating graft function, at 5 years, we observed the serum creatinine level ( P = .0001) and the estimated glomerular filtration rate ( P = .003) are significantly different between the two groups. At this time there was a significant difference in the serum creatinine level of patients who were older than the age of 55 years compared with those who showed hypertension ( P = .0003). Evaluating morphological changes in the kidneys, acute rejection episodes ( P = .0004) and interstitial fibrosis/tubular atrophy ( P = .002) were significantly greater among the marginal versus the ideal groups. At 1 year after kidney transplantation, despite no significant difference regarding renal function, they were significant in the histology of marginal versus ideal donor kidneys.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2012.07.121