SP776IMPACT OF PRE-TRANSPLANT HISTOLOGICAL SCORE ON FIVE YEARS GRAFT OUTCOMES OF KIDNEYS FROM MARGINAL DONORS: A SINGLE-CENTRE STUDY

Abstract

Introduction and Aims: Whether pre-transplant kidney biopsy must be used to assess if kidneys from extended criteria donors must be allocated to single or dual transplantation is still a matter of debate. The aim of this study was to compare 5 years graft outcome and renal function between ecipients of a single kidney graft from a marginal donor with a Karpinski histological score of ≤3 and recipients of a single transplant with a Karpinski score of 4 or 5. Methods: This is a 5 years follow up extension of a previous study where we compared retrospectively 3 years graft survival and renal function in 44 recipients of a single kidney graft from a marginal donor with good renal function and a Karpinski histological score of ≤3 and 56 recipients of a single transplant with a Karpinski score of 4 or 5. The donors' and recipients' characteristics were compared by means of Wilcoxon's rank-sum test and Fisher's exact test, and survival was analysed using the log-rank test and Cox regression survival analysis. Results: The donors with the worse histological scores were slightly younger (68.0 ±4.74 vs 71.3±4.6 years, p <0.01 ) and had a higher glomerular filtration rate (85.8 ±28.2 vs 76.3±26.53 mL/min, p= 0.013), but there was no difference in serum creatinine levels (0.83±0.24 vs 0.85±0.30 mg/dL, p=0.381). Five years after transplantation, there was no difference between the two groups in terms of recipient serum creatinine levels (1.8±0.5 vs 1.9±0.6 mg/dL, p=0.5), creatinine clearance (53 ±23 vs 49±27.0 mL/min, p=0.6) or the rates of graft loss (35% Vs 29 % vs p=0.5), Conclusions: In our experience, provided the donor has a normal renal function, a difference in the pre-transplant histological score of kidneys from marginal cadaveric donors does not have a significant influence on outcome five years after transplantation.