Donor Kidney Biopsies not useful in Transplant Outcome Prediction; finds study
Many kidneys donated for transplant in the United States are discarded because of abnormal histology. Whether histology adds incremental value beyond usual donor attributes in assessing allograft quality is still unknown. It is also unknown whether preimplantation kidney biopsies that are routinely performed in the United States add incremental value beyond usual donor attributes in predicting allograft survival.
In a recent study published in the Journal of American Society of Nephrology ,The investigators analyzed detailed data from transplant centers in France and Belgium, where pretransplant biopsies are prospectively performed as standard practice but do not guide decision making for organ allocation.
This population-based study included patients who received a deceased donor kidney that had been biopsied before implantation according to a prespecified protocol in France and Belgium, where preimplantation biopsy findings are generally not used for decision making in the allocation process. We also studied kidneys that had been acquired from deceased United States donors for transplantation that were biopsied during allocation and discarded because of low organ quality. Using donor and recipient characteristics, we fit multivariable Cox models for death-censored graft failure and examined whether predictive accuracy (C index) improved after adding donor histology. We matched the discarded United States kidneys to similar kidneys transplanted in Europe and calculated predicted allograft survival.
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