Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Pathology

Donor biopsy evaluation at time of renal grafting

Nature Reviews Nephrology volume 5, pages 249–251 (2009)Cite this article

How can we improve the diagnostic value of donor kidney graft biopsies and the management of renal transplant recipients? A recent study developed a morphologic scoring system—the Maryland Aggregate Pathology Index—to help predict long-term renal graft survival from preimplantation donor organ biopsy findings.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1: A renal graft biopsy sample 12 days after transplantation that shows combination injury: pre-existing, moderate, donor-derived intimal fibroelastosis/arteriosclerosis (asterisks) and superimposed de novo transplant endarteritis (Banff type II cellular rejection).

References

  1. Munivenkatappa, R. B. et al. The Maryland aggregate pathology index: a deceased donor kidney biopsy scoring system for predicting graft failure. Am. J. Transplant. 8, 2316–2324 (2008).

    Article  CAS  Google Scholar 

  2. Solez, K. et al. Banff 07 classification of renal allograft pathology: updates and future directions. Am. J. Transplant. 8, 753–760 (2008).

    Article  CAS  Google Scholar 

  3. Racusen, L. C. et al. The Banff 97 working classification of renal allograft pathology. Kidney Int. 55, 713–723 (1999).

    Article  CAS  Google Scholar 

  4. Solez, K. et al. International standardization of criteria for the histologic diagnosis of renal allograft rejection: the Banff working classification of kidney transplant pathology. Kidney Int. 44, 411–422 (1993).

    Article  CAS  Google Scholar 

  5. Remuzzi, G. et al. Long-term outcome of renal transplantation from older donors. N. Engl. J. Med. 354, 343–352 (2006).

    Article  CAS  Google Scholar 

  6. Fritsche, L. et al. Old-for-old kidney allocation allows successful expansion of the donor and recipient pool. Am. J. Transplant. 3, 1434–1439 (2003).

    Article  Google Scholar 

  7. Segoloni, G. P. et al. Preferential allocation of marginal kidney allografts to elderly recipients combined with modified immunosuppression gives good results. Transplantation 80, 953–958 (2005).

    Article  Google Scholar 

  8. Smits, J. M., Persijn, G. G., van Houwelingen, H. C., Claas, F. H. & Frei, U. Evaluation of the Eurotransplant Senior Program. The results of the first year. Am. J. Transplant. 2, 664–670 (2002).

    Article  Google Scholar 

  9. Savoye, E., Tamarelle, D., Chalem, Y., Rebibou, J. M. & Tuppin, P. Survival benefits of kidney transplantation with expanded criteria deceased donors in patients aged 60 years and over. Transplantation 84, 1618–1624 (2007).

    Article  Google Scholar 

  10. Frei, U. et al. Prospective age-matching in elderly kidney transplant recipients—a 5-year analysis of the Eurotransplant Senior Program. Am. J. Transplant. 8, 50–57 (2008).

    CAS  PubMed  Google Scholar 

  11. Haas, M., Ratner, L. E. & Montgomery, R. A. C4d staining of perioperative renal transplant biopsies. Transplantation 74, 711–717 (2002).

    Article  CAS  Google Scholar 

  12. Nickeleit, V. Pathology of renal transplantation. in Transplantation Pathology (ed. Ruiz, P.) 45–110 (Cambridge University Press, 2009).

    Google Scholar 

  13. Pascual, J., Marcén, R. & Ortuño, J. Clinical experience with everolimus (Certican) in elderly recipients: the “old-for-old” concept. Transplantation 79, S85–S88 (2005).

    Article  CAS  Google Scholar 

  14. Gill, J. et al. Outcomes of kidney transplantation from older living donors to older recipients. Am. J. Kidney Dis. 52, 541–552 (2008).

    Article  Google Scholar 

  15. Arns, W., Citterio, F. & Campistol, J. M. 'Old-for-old'—new strategies for renal transplantation. Nephrol. Dial. Transplant. 22, 336–341 (2007).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology and Laboratory Medicine, Nephropathology Unit, University of North Carolina Medical School, Chapel Hill, NC, USA

    Volker Nickeleit

Authors
  1. Volker Nickeleit
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Volker Nickeleit.

Ethics declarations

Competing interests

The author declares no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nickeleit, V. Donor biopsy evaluation at time of renal grafting. Nat Rev Nephrol 5, 249–251 (2009). https://doi.org/10.1038/nrneph.2009.50

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrneph.2009.50

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing