Clinical study on kidney allograft transplantation from marginal donors with high pathological Remuzzi score in preimplantation biopsy
10.3760/cma.j.cn421203-20200820-00299
- VernacularTitle:移植前活检Remuzzi高评分供肾移植的临床观察
- Author:
Man ZHANG
1
;
Huibo SHI
;
Bin LIU
;
Fanjun ZENG
;
Weijie ZHANG
;
Hui GUO
;
Zhishui CHEN
Author Information
1. 华中科技大学同济医学院附属同济医院器官移植研究所 教育部器官移植重点实验室 国家卫生健康委员会器官移植重点实验室 中国医学科学院器官移植重点实验室,武汉 430030
- Keywords:
Kidney transplantation;
Marginal donated kidney;
Kidney biopsy
- From:
Chinese Journal of Organ Transplantation
2021;42(9):518-523
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the outcome of kidney transplantation from donation after cadaveric death(DCD)with high pathological Remuzzi score.Methods:From January, 2019 to December, 2019, 31 recipients of kidney allograft transplantation from marginal donors with Remuzzi score≥4 in preimplantation biopsy were retrospectively enrolled. They were divided into two groups of dual kidney transplantation(DKT, 14 cases)and single kidney transplantation(SKT, 17 cases). Median Remuzzi score of left kidney(5.05 in DKT group vs 4.92 in SKT group)or right kidney(5.26 vs. 4.58)was comparable. Dual donor kidneys were implanted into ipsilateral iliac fossa. Survival outcomes, kidney function, acute rejection episodes, incidence of delayed graft function(DGF)and proteinuria were recorded within Year 1 post-operation.Results:Proportion of male(92.9% vs. 52.9%, P<0.05)and recipient's body mass index(BMI, 23.93 vs. 21.09)were significant higher in DKT group than those in SKT group. One graft failure occurred in DKT group at Month 11 post-operation. The 1-year graft survival rate was 92.9% in DKT group and 1-year recipient survival rate both 100% in two groups. Mean 12-month serum creatinine[SCr, (164±37.7)μmol/L vs. (154.92±96.2)μmol/L]and estimated glomerular filtration rate[eGFR, (41.84±9.01) vs. (44.8±18.16)ml/(min·1.73m 2)]were comparable between two groups(both P>0.05). There was no occurrence of thrombosis resulting in graft loss. One-year incidence of acute rejection, rate of DGF(42.9% vs 41.2%)and proteinuria(57.1% vs. 41.2%)were comparable between two groups(both P>0.05). Conclusions:Through donor-recipient matching and dual kidney transplant allocation, short-term survival outcome of kidney allograft from marginal donors with high Remuzzi score≥4 is encouraging. However, long-term outcomes should be further examined.