Prevalence of abdominal aortic calcifications in older living renal donors and its effect on graft function and histology.

Abstract

We assessed the prevalence of abdominal aortic calcification (AAC) in older living kidney donors and its effect on recipient eGFR and graft histology. A total of 292 consecutive living pairs with donor age ≥50 from 2003 to 2013 were identified (mean age 56; range 50-78; F/M: 1.8). Donor AAC was determined by prenephrectomy unenhanced CT. Recipient eGFR and spot urine protein: creatinine ratios (UPCRs) were recorded. A total of 180 recipients had 6-month protocol biopsies. AAC was present in 40.7% of donors, and they were older (58.6 versus 54.7 years old, P < 0.0001) and more likely to be male (77.6% vs. 37.3%, P = 0.004). There was no significant difference in eGFR or spot UPCR up to 36 months in recipients of allografts from donors with versus without AAC. At 6-month biopsy, there was a higher percentage of allografts with vascular fibrous intimal thickening and arteriolar hyaline thickening from donors with versus without AAC (vascular fibrous intimal thickening: 38.8% vs. 7.1% and arteriolar hyaline thickening: 35.8% vs. 7.1%; P < 0.001 for both). The presence of donor AAC predicts the presence of vascular disease [vascular fibrous intimal thickening (OR: 7.2; CI:2.9-17.9) and arteriolar hyaline thickening (OR:5.7; CI:2.3-14.1)] in allografts at 6 months. Donor AAC is predictive of renal vascular disease and may help to improve the screening of potential donors and inform post-transplant management.

• Authors: En-Haw Wu, David Wojciechowski, Sindhu Chandran, Benjamin M Yeh, Meyeon Park, Antonio Westphalen, Zhen J Wang
• Journal: Transplant international : official journal of the European Society for Organ Transplantation (Transpl Int) Vol. 28 Issue 10 Pg. 1172-8 (Oct 2015) ISSN: 1432-2277 [Electronic] Switzerland
• PMID: 26011061 (Publication Type: Journal Article)
• Copyright: © 2015 Steunstichting ESOT.

Chemical References

• Creatinine

Topics

• Age Factors
• Aorta, Abdominal (diagnostic imaging, pathology)
• Aortic Diseases (diagnostic imaging, epidemiology, physiopathology)
• Aortography
• Arterioles (pathology)
• Atherosclerosis (diagnostic imaging, epidemiology, physiopathology)
• Biopsy
• Creatinine (urine)
• Donor Selection
• Female
• Glomerular Filtration Rate
• Humans
• Kidney (blood supply, diagnostic imaging, physiology, ultrastructure)
• Kidney Transplantation
• Living Donors
• Male
• Middle Aged
• Prevalence
• Proteinuria (epidemiology)
• Retrospective Studies
• Tomography, X-Ray Computed
• Treatment Outcome
• Tunica Intima (pathology)
• Vascular Calcification (diagnostic imaging, epidemiology, physiopathology)