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Histological assessment of pre‐transplant kidney biopsies is reproducible and representative
Author(s) -
Snoeijs Maarten G J,
Boonstra Liesbeth A,
Buurman Wim A,
Goldschmeding Roel,
Van Suylen Robert Jan,
Van Heurn L W Ernest,
PeutzKootstra Carine J
Publication year - 2010
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.2009.03469.x
Subject(s) - medicine , biopsy , transplantation , intraclass correlation , kidney , autopsy , radiology , kidney transplantation , pathology , surgery , clinical psychology , psychometrics
Snoeijs M G J, Boonstra L A, Buurman W A, Goldschmeding R, van Suylen R J, van Heurn L W E & Peutz‐Kootstra C J
(2010) Histopathology 56, 198–202 Histological assessment of pre‐transplant kidney biopsies is reproducible and representativeAims: Histological examination of pre‐transplant renal biopsy specimens can be used to select grafts from older donors after cardiac death (DCD) with a satisfactory transplant outcome. The aim was to determine whether such biopsy specimens can be reproducibly scored between pathologists and are representative of the whole kidney. Methods and results: In renal biopsy specimens from DCD aged ≥60 years ( n = 44), globally sclerosed glomeruli, vascular narrowing, tubular atrophy and interstitial fibrosis were scored by three independent pathologists according to the Pirani scoring system. Interobserver agreement on the sum of scores improved considerably with the introduction of a combined tubulo‐interstitial scoring system (intraclass correlation coefficient increased from 0.38 to 0.64). In small needle biopsy specimens ( n = 144) obtained at autopsy, estimates of the proportion of globally sclerosed glomeruli were more precise with increasing sample size. Reasonably precise estimates may be obtained from specimens with at least seven glomeruli. Conclusions: It is feasible to implement pre‐transplant renal biopsy specimen analysis as a selection criterion in clinical practice in order to accept kidneys from marginal donors for transplantation.