Significato prognostico delle lesioni istopatologiche del donatore di rene

The number of patients on the waiting list for kidney transplantation is increasing. They have been proposed some strategies to expand the donor pool including the use of donors 'marginal' (ECD). This study was carried out with the aim to evaluate the prognostic significance of renal histopathological lesions on outcome of the transplant. They evaluated 277 patients transplanted from deceased donors (standard donors vs ECD) in the period from 2013 to 2016 at the Transplant Center of Bologna. 124 were potential ECD; 84 were employed in individual transplants and 40 in tandem transplant. The cardiovascular disease, cerebrovascular death, the weight and age of the donor were prognostic trend of renal function in the short term. The ischemic times are longer in the ECD with statistically significant differences. The ECD status is also significantly correlated with ischemia time, with DGF and is a prognostic factor on the performance of graft in relation to proteinuria in three years. The incidence of rejection is similar in the two groups but was one predictor variable of DGF and prognostically relata with creatinine at 1 and 2 years. With respect to renal histopathological lesions only damage to the glomerular compartment level is prognostic outcome on renal function follow-up in the immediate short term. The total score and the vascular damage were directly related to the age of the donor and the total score inversely to the hearsay proteinuria at 1 year after transplantation. From the results obtained it can be said that it might be useful to reduce the number of donors undergoing renal biopsy, limiting its application to those cases in which the risk of non-organ suitability is considerably higher. The integration and coexistence of two classification systems, histological and clinical hypothesis appears ameliorative able to allow a more appropriate use of renal biopsy.