A kidney discard decision strategy based on zero‐time histology analysis could lead to an unjustified increase in the organ turndown rate among ECD
Summary The utility of zero‐time kidney biopsies (KB) in deciding to accept expanded criteria donor (ECD) kidneys remains controversial. However, zero‐time histology is one of the main causes for discarding kidneys in the United States. In a single‐centre study, we examined the utility and impact on...
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| Veröffentlicht in: | Transplant international 2021-08, Vol.34 (8), p.1506-1516 |
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| creator | Luque, Yosu Jamme, Matthieu Aubert, Olivier Roux, Arthur Martinez, Frank Amrouche, Lucile Tinel, Claire Galmiche, Louise Duong Van Huyen, Jean‐Paul Audenet, François Legendre, Christophe Anglicheau, Dany Rabant, Marion |
| description | Summary
The utility of zero‐time kidney biopsies (KB) in deciding to accept expanded criteria donor (ECD) kidneys remains controversial. However, zero‐time histology is one of the main causes for discarding kidneys in the United States. In a single‐centre study, we examined the utility and impact on outcome of the use of frozen section zero‐time KB among ECD. Ninety‐two zero‐time KB were analysed for accept/discard decision between 2005 and 2015 among ECD. 53% of kidneys were rejected after zero‐time KB analysis; there was no difference in individual clinical and biological data between accepted/rejected groups. However, histology of rejected kidneys showed more sclerotic glomeruli (20% vs. 8%; P |
| doi_str_mv | 10.1111/tri.13933 |
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The utility of zero‐time kidney biopsies (KB) in deciding to accept expanded criteria donor (ECD) kidneys remains controversial. However, zero‐time histology is one of the main causes for discarding kidneys in the United States. In a single‐centre study, we examined the utility and impact on outcome of the use of frozen section zero‐time KB among ECD. Ninety‐two zero‐time KB were analysed for accept/discard decision between 2005 and 2015 among ECD. 53% of kidneys were rejected after zero‐time KB analysis; there was no difference in individual clinical and biological data between accepted/rejected groups. However, histology of rejected kidneys showed more sclerotic glomeruli (20% vs. 8%; P < 0.001), increased interstitial fibrosis (1.25 ± 0.12 vs. 0.47 ± 0.09; P < 0.0001), more arteriosclerosis (2.14 ± 0.17 vs. 1.71 ± 0.11; P = 0.0032) and arteriolar hyalinosis (2.15 ± 0.12 vs. 1.55 ± 0.11; P = 0.0006). Using propensity score matching, we generated a group of 42 kidney allograft recipients who received a transplant matched for donor zero‐time histology and clinical characteristics with donors whose kidneys were rejected. Interestingly, their 1‐ and 5‐year graft survival and function were similar to the global cohort of ECD recipients. In conclusion, when performed, zero‐time KB was a decisive element for kidney discard decision. However, adverse zero‐time histology was not associated with poorer graft survival and kidney function among ECD.
When performed, zero‐time KB was a decisive element for kidney discard decision. However, adverse zero‐time histology was not associated with poorer graft survival and kidney function among ECD.</description><identifier>ISSN: 0934-0874</identifier><identifier>EISSN: 1432-2277</identifier><identifier>DOI: 10.1111/tri.13933</identifier><identifier>PMID: 34097778</identifier><language>eng</language><publisher>HOBOKEN: Wiley</publisher><subject>Arteriosclerosis ; Decision analysis ; Fibrosis ; Histology ; histopathology ; kidney biopsy ; Kidney transplantation ; Kidney transplants ; Kidneys ; Life Sciences & Biomedicine ; Science & Technology ; Surgery ; Survival ; transplant outcomes ; Transplantation ; zero‐time biopsy</subject><ispartof>Transplant international, 2021-08, Vol.34 (8), p.1506-1516</ispartof><rights>2021 Steunstichting ESOT. Published by John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>2</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000670586200001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c3303-d3a062a8ab52c7148f9421ccf7124a7e8d5384550688236d875198feef4545803</citedby><cites>FETCH-LOGICAL-c3303-d3a062a8ab52c7148f9421ccf7124a7e8d5384550688236d875198feef4545803</cites><orcidid>0000-0002-3172-6571 ; 0000-0001-5696-6478 ; 0000-0003-4595-7570</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Ftri.13933$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Ftri.13933$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,39263,45579,45580</link.rule.ids></links><search><creatorcontrib>Luque, Yosu</creatorcontrib><creatorcontrib>Jamme, Matthieu</creatorcontrib><creatorcontrib>Aubert, Olivier</creatorcontrib><creatorcontrib>Roux, Arthur</creatorcontrib><creatorcontrib>Martinez, Frank</creatorcontrib><creatorcontrib>Amrouche, Lucile</creatorcontrib><creatorcontrib>Tinel, Claire</creatorcontrib><creatorcontrib>Galmiche, Louise</creatorcontrib><creatorcontrib>Duong Van Huyen, Jean‐Paul</creatorcontrib><creatorcontrib>Audenet, François</creatorcontrib><creatorcontrib>Legendre, Christophe</creatorcontrib><creatorcontrib>Anglicheau, Dany</creatorcontrib><creatorcontrib>Rabant, Marion</creatorcontrib><title>A kidney discard decision strategy based on zero‐time histology analysis could lead to an unjustified increase in the organ turndown rate among ECD</title><title>Transplant international</title><addtitle>TRANSPL INT</addtitle><description>Summary
The utility of zero‐time kidney biopsies (KB) in deciding to accept expanded criteria donor (ECD) kidneys remains controversial. However, zero‐time histology is one of the main causes for discarding kidneys in the United States. In a single‐centre study, we examined the utility and impact on outcome of the use of frozen section zero‐time KB among ECD. Ninety‐two zero‐time KB were analysed for accept/discard decision between 2005 and 2015 among ECD. 53% of kidneys were rejected after zero‐time KB analysis; there was no difference in individual clinical and biological data between accepted/rejected groups. However, histology of rejected kidneys showed more sclerotic glomeruli (20% vs. 8%; P < 0.001), increased interstitial fibrosis (1.25 ± 0.12 vs. 0.47 ± 0.09; P < 0.0001), more arteriosclerosis (2.14 ± 0.17 vs. 1.71 ± 0.11; P = 0.0032) and arteriolar hyalinosis (2.15 ± 0.12 vs. 1.55 ± 0.11; P = 0.0006). Using propensity score matching, we generated a group of 42 kidney allograft recipients who received a transplant matched for donor zero‐time histology and clinical characteristics with donors whose kidneys were rejected. Interestingly, their 1‐ and 5‐year graft survival and function were similar to the global cohort of ECD recipients. In conclusion, when performed, zero‐time KB was a decisive element for kidney discard decision. However, adverse zero‐time histology was not associated with poorer graft survival and kidney function among ECD.
When performed, zero‐time KB was a decisive element for kidney discard decision. However, adverse zero‐time histology was not associated with poorer graft survival and kidney function among ECD.</description><subject>Arteriosclerosis</subject><subject>Decision analysis</subject><subject>Fibrosis</subject><subject>Histology</subject><subject>histopathology</subject><subject>kidney biopsy</subject><subject>Kidney transplantation</subject><subject>Kidney transplants</subject><subject>Kidneys</subject><subject>Life Sciences & Biomedicine</subject><subject>Science & Technology</subject><subject>Surgery</subject><subject>Survival</subject><subject>transplant outcomes</subject><subject>Transplantation</subject><subject>zero‐time biopsy</subject><issn>0934-0874</issn><issn>1432-2277</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><recordid>eNqNkc9qFTEUxgdR7LW68A0CbhSZNpM_k8yyjFULBUHqeshNztzmOjepSYYyrnyEbvqCPonneosLQfBsEk5-5zsf-arqZUNPGqzTkvxJwzvOH1WrRnBWM6bU42pFOy5qqpU4qp7lvKWUMi3p0-qIC9oppfSquj8jX70LsBDnszXJEQfWZx8DySWZApuFrE0GR7DzHVL8-eOu-B2Qa59LnCI-m2CmJftMbJwnRyYwjpSIbTKH7ZyLHz2O-2AToBBeSLkGEtMGiTKn4OJtIPtVxOxi2JDz_t3z6slopgwvHs7j6sv786v-Y3356cNFf3ZZW84prx03tGVGm7VkVjVCj51gjbWjapgwCrSTXAspaas1463TSjadHgFGIYXUlB9Xrw-6Nyl-myGXYYe_ANNkAsQ5D0zyjuEKyhF99Re6jWge3SHVUsFb1TZIvTlQNsWcE4zDTfI7k5ahocM-qwGzGn5nhezbA3sL6zhm6yFY-MNjWK2iUuNyrL2y_n-698UUzLCPcyg4evow6idY_u1ouPp8cbD2C7dgtfY</recordid><startdate>202108</startdate><enddate>202108</enddate><creator>Luque, Yosu</creator><creator>Jamme, Matthieu</creator><creator>Aubert, Olivier</creator><creator>Roux, Arthur</creator><creator>Martinez, Frank</creator><creator>Amrouche, Lucile</creator><creator>Tinel, Claire</creator><creator>Galmiche, Louise</creator><creator>Duong Van Huyen, Jean‐Paul</creator><creator>Audenet, François</creator><creator>Legendre, Christophe</creator><creator>Anglicheau, Dany</creator><creator>Rabant, Marion</creator><general>Wiley</general><general>Blackwell Publishing Ltd</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7T5</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3172-6571</orcidid><orcidid>https://orcid.org/0000-0001-5696-6478</orcidid><orcidid>https://orcid.org/0000-0003-4595-7570</orcidid></search><sort><creationdate>202108</creationdate><title>A kidney discard decision strategy based on zero‐time histology analysis could lead to an unjustified increase in the organ turndown rate among ECD</title><author>Luque, Yosu ; Jamme, Matthieu ; Aubert, Olivier ; Roux, Arthur ; Martinez, Frank ; Amrouche, Lucile ; Tinel, Claire ; Galmiche, Louise ; Duong Van Huyen, Jean‐Paul ; Audenet, François ; Legendre, Christophe ; Anglicheau, Dany ; Rabant, Marion</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3303-d3a062a8ab52c7148f9421ccf7124a7e8d5384550688236d875198feef4545803</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Arteriosclerosis</topic><topic>Decision analysis</topic><topic>Fibrosis</topic><topic>Histology</topic><topic>histopathology</topic><topic>kidney biopsy</topic><topic>Kidney transplantation</topic><topic>Kidney transplants</topic><topic>Kidneys</topic><topic>Life Sciences & Biomedicine</topic><topic>Science & Technology</topic><topic>Surgery</topic><topic>Survival</topic><topic>transplant outcomes</topic><topic>Transplantation</topic><topic>zero‐time biopsy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Luque, Yosu</creatorcontrib><creatorcontrib>Jamme, Matthieu</creatorcontrib><creatorcontrib>Aubert, Olivier</creatorcontrib><creatorcontrib>Roux, Arthur</creatorcontrib><creatorcontrib>Martinez, Frank</creatorcontrib><creatorcontrib>Amrouche, Lucile</creatorcontrib><creatorcontrib>Tinel, Claire</creatorcontrib><creatorcontrib>Galmiche, Louise</creatorcontrib><creatorcontrib>Duong Van Huyen, Jean‐Paul</creatorcontrib><creatorcontrib>Audenet, François</creatorcontrib><creatorcontrib>Legendre, Christophe</creatorcontrib><creatorcontrib>Anglicheau, Dany</creatorcontrib><creatorcontrib>Rabant, Marion</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transplant international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Luque, Yosu</au><au>Jamme, Matthieu</au><au>Aubert, Olivier</au><au>Roux, Arthur</au><au>Martinez, Frank</au><au>Amrouche, Lucile</au><au>Tinel, Claire</au><au>Galmiche, Louise</au><au>Duong Van Huyen, Jean‐Paul</au><au>Audenet, François</au><au>Legendre, Christophe</au><au>Anglicheau, Dany</au><au>Rabant, Marion</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A kidney discard decision strategy based on zero‐time histology analysis could lead to an unjustified increase in the organ turndown rate among ECD</atitle><jtitle>Transplant international</jtitle><stitle>TRANSPL INT</stitle><date>2021-08</date><risdate>2021</risdate><volume>34</volume><issue>8</issue><spage>1506</spage><epage>1516</epage><pages>1506-1516</pages><issn>0934-0874</issn><eissn>1432-2277</eissn><abstract>Summary
The utility of zero‐time kidney biopsies (KB) in deciding to accept expanded criteria donor (ECD) kidneys remains controversial. However, zero‐time histology is one of the main causes for discarding kidneys in the United States. In a single‐centre study, we examined the utility and impact on outcome of the use of frozen section zero‐time KB among ECD. Ninety‐two zero‐time KB were analysed for accept/discard decision between 2005 and 2015 among ECD. 53% of kidneys were rejected after zero‐time KB analysis; there was no difference in individual clinical and biological data between accepted/rejected groups. However, histology of rejected kidneys showed more sclerotic glomeruli (20% vs. 8%; P < 0.001), increased interstitial fibrosis (1.25 ± 0.12 vs. 0.47 ± 0.09; P < 0.0001), more arteriosclerosis (2.14 ± 0.17 vs. 1.71 ± 0.11; P = 0.0032) and arteriolar hyalinosis (2.15 ± 0.12 vs. 1.55 ± 0.11; P = 0.0006). Using propensity score matching, we generated a group of 42 kidney allograft recipients who received a transplant matched for donor zero‐time histology and clinical characteristics with donors whose kidneys were rejected. Interestingly, their 1‐ and 5‐year graft survival and function were similar to the global cohort of ECD recipients. In conclusion, when performed, zero‐time KB was a decisive element for kidney discard decision. However, adverse zero‐time histology was not associated with poorer graft survival and kidney function among ECD.
When performed, zero‐time KB was a decisive element for kidney discard decision. However, adverse zero‐time histology was not associated with poorer graft survival and kidney function among ECD.</abstract><cop>HOBOKEN</cop><pub>Wiley</pub><pmid>34097778</pmid><doi>10.1111/tri.13933</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-3172-6571</orcidid><orcidid>https://orcid.org/0000-0001-5696-6478</orcidid><orcidid>https://orcid.org/0000-0003-4595-7570</orcidid></addata></record> |
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| subjects | Arteriosclerosis Decision analysis Fibrosis Histology histopathology kidney biopsy Kidney transplantation Kidney transplants Kidneys Life Sciences & Biomedicine Science & Technology Surgery Survival transplant outcomes Transplantation zero‐time biopsy |
| title | A kidney discard decision strategy based on zero‐time histology analysis could lead to an unjustified increase in the organ turndown rate among ECD |
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