Early changes in scores of chronic damage on transplant kidney protocol biopsies reflect donor characteristics, but not future graft function

• Published in: Clinical transplantation 2013-11, Vol.27 (6), p.E669-E678
• Main Authors: Caplin, Ben, Veighey, Kristin, Mahenderan, Arundathi, Manook, Miriam, Henry, Joanne, Nitsch, Dorothea, Harber, Mark, Dupont, Peter, Wheeler, David C., Jones, Gareth, Fernando, Bimbi, Howie, Alexander J., Veitch, Peter
• Format: Article
• Language: English
• Subjects: Adult; Biopsy; chronic allograft injury; chronic damage index; Cohort Studies; digital image analysis; Female; Follow-Up Studies; Glomerular Filtration Rate; Graft Rejection - diagnosis; Graft Rejection - etiology; Graft Survival; Humans; Kidney Failure, Chronic - diagnosis; Kidney Failure, Chronic - etiology; Kidney Failure, Chronic - surgery; Kidney Function Tests; Kidney Transplantation; Living Donors; Male; Middle Aged; Original; Postoperative Complications; Prognosis; protocol biopsy; renal transplantation; Transplantation, Homologous
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/ctr.12251

The amount of irreversible injury on renal allograft biopsy predicts function, but little is known about the early evolution of this damage. In a single‐center cohort, we examined the relationship between donor‐, recipient‐, and transplantation‐associated factors and change in a morphometric index of chronic damage (ICD) between protocol biopsies performed at implantation and at 2–3 months. We then investigated whether early delta ICD predicted subsequent biochemical outcomes. We found little evidence to support differences between the study group, who had undergone serial biopsies, and a contemporaneous control group, who had not. In allografts with serial biopsies (n = 162), there was an increase in ICD between implantation (median: 2%, IQR:0–8) and 2–3 months post‐transplant (median 8% IQR:4–15; p