Procurement Bx of Deceased Donor Kidneys Poorly Reproduced
FRIDAY, Oct. 26, 2018 -- Procurement biopsies from deceased donor kidneys have poor reproducibility and do not correlate well with reperfusion biopsies, according to a study published online Oct. 25 in the Clinical Journal of the American Society of Nephrology to coincide with a presentation at ASN Kidney Week 2018, held Oct. 23 to 28 in San Diego.
Dustin Carpenter, M.D., from Columbia University College of Physicians and Surgeons in New York City, and colleagues compared procurement frozen section biopsy reports with reperfusion paraffin-embedded biopsies read by trained pathologists for 270 kidneys from deceased donors. Agreement for sequential procurement biopsies performed on the same kidney was also examined (n = 116).
The researchers found category agreement in 64 percent of the kidneys on which more than one procurement biopsy was performed (κ = 0.14). The correlation between procurement and reperfusion biopsies was poor for all kidneys. In 64 percent of cases, biopsies were classified into the same category (optimal versus suboptimal; κ = 0.25). When categorizing the percentage of glomerulosclerosis, this discrepancy was most pronounced (63 percent agreement; κ = 0.15). Overall, reperfusion biopsies were more prognostic than procurement biopsies, with no significant correlation for procurement biopsies with graft failure.
"Limited reliance on procurement biopsy histology will likely result in an improvement in organ utilization by reducing the discard of kidneys attributable to these findings," said a co-author in a statement.
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Posted: October 2018