Comparison Between Clinical and Histopathological Scoring in Cadaveric Kidney Transplantation and Its Correlation With Posttransplant Evolution

Abstract Introduction There are several scoring systems, both clinical (Deceased Donor Score [DDS]) and histopathological (Remuzzi [REM]), that attempt to determine acceptability criteria for deceased donor kidney transplant. A retrospective study was performed among a group of kidney transplant recipients to evaluate posttransplant evolution with clinical and histopathological scores. Materials and methods Among 107 first deceased donor kidney transplant patients, 95 had undergone a pretransplant biopsy. Donor age was 38.46 ± 16.9 years; recipient age: 49.2 ± 16.3 years; DDS was 15.58 ± 7.29. REM was 2.89 ± 1.7. Delayed graft function was 64.2%. Induction therapy was administered to 49.5%. Cold ischemia time (CIT) was 1364 ± 348 minute. Time on dialysis was 2275 ± 1501 days. Induction therapy, immunosuppressive regimens, CIT, and time on dialysis were not significantly different among the groups. One-year patient and graft survival were 94.5% and 86%, respectively and 2-year values, 92.6% and 81%, respectively. Conclusion DDS showed a significant correlation with serum creatinine values over 1 and 2 years. REM did not show a significant association with any events. The differences were sustained after adjusting for other variables. Graft survival maintained a strong correlation with DDS categories and no association with REM. The clinical characteristics of a deceased donor appeared to be of greater importance than the biopsy findings in terms of posttransplant events.