Donor Kidney Biopsies Do Not Aid Transplant Outcome Prediction

WEDNESDAY, Dec. 30, 2020 -- Use of kidney biopsy results from deceased donor kidneys does not improve prediction of allograft survival, according to a study published online Dec. 15 in the Journal of the American Society of Nephrology.

Peter P. Reese, M.D., from the Université de Paris, and colleagues conducted a population-based study involving patients who received a deceased donor kidney that had been biopsied before implantation in France and Belgium. Kidneys that had been acquired from deceased U.S. donors for transplantation and were discarded due to low organ quality were also studied.

The researchers found that adding donor histology did not significantly improve prediction of long-term allograft failure in the development cohort of 1,629 kidney recipients at two French centers. The lack of improved accuracy from adding histology was confirmed in an external validation cohort from two Belgian centers. Of 1,103 U.S. kidneys discarded due to histologic findings, about 45 percent could be accurately matched to very similar kidneys that had been transplanted in France; the allograft survival of these discarded kidneys was expected to be 93.1, 80.7, and 68.9 percent at one, five, and 10 years, respectively.

"These results add to a growing body of evidence that a ready opportunity exists for U.S. centers to increase the number of kidney transplants by adopting evidence-based standards for organ acceptance," the authors write. "This report provides a strong rationale for organ procurement organizations to reduce the routine practice of obtaining biopsies of deceased donor kidneys."

Several authors disclosed financial ties to the pharmaceutical industry.

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Posted: December 2020