The prognostic value of frozen section preimplantation graft biopsy in the outcome of renal transplantation.

Abstract:

INTRODUCTION:Preimplantation biopsy provides a window on the state of the renal allograft. In this study, the prognostic value of frozen section preimplantation graft biopsy was estimated and compared to regularly processed formalin-fixed biopsy. MATERIALS AND METHODS:Seventy-four renal allograft recipients were studied. The degree of glomerulosclerosis, acute tubular necrosis, interstitial fibrosis, arteriosclerosis, and arteriolosclerosis was rapidly estimated in frozen sections and correlated to the renal function in the immediate posttransplantation period and 3 months thereafter. The histological changes were also examined in paraffin-embedded sections. RESULTS:The histological changes observed in rapidly processed frozen sections were comparable to those observed on regularly processed sections and their differences did not reach statistical significance. Glomerulosclerosis and arteriolosclerosis were underestimated, whereas acute tubular necrosis and interstitial fibrosis were overestimated, in the frozen sections compared to permanent ones, but those differences were not statistically significant. Immediate graft function was observed in 45 patients (61%). Delayed graft function was more frequently observed among recipients with donor age above 60 years (57% vs. 32%). Serum creatinine 3 months after transplantation was above 2 mg/dL in 33 recipients (44.5%) and was positively correlated to the degree of tubular necrosis (p = 0.04) and donor age (p = 0.03). Donor age was correlated to the degree of arteriolosclerosis (p < 0.01). CONCLUSIONS:Frozen section preimplantation biopsy gives reliable information for the situation of the graft that is related to the outcome of renal transplantation.

journal_name

Ren Fail

journal_title

Renal failure

authors

Goumenos DS,Kalliakmani P,Tsamandas AC,Maroulis I,Savidaki E,Fokaefs E,Papachristou E,Karavias D,Vlachojannis JG

doi

10.3109/08860221003658241

subject

Has Abstract

pub_date

2010-05-01 00:00:00

pages

434-9

issue

4

eissn

0886-022X

issn

1525-6049

journal_volume

32

pub_type

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