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Kidney Week

Abstract: TH-PO1131

Interstitial Fibroblasts in Donor Kidney Predict Late Post-Transplant Anemia

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Kawabe, Mayuko, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Mafune, Aki Hamada, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Yamamoto, Izumi, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Yamakawa, Takafumi, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Katsumata, Haruki, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Katsuma, Ai, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Nakada, Yasuyuki, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Kobayashi, Akimitsu, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Tanno, Yudo, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Ohkido, Ichiro, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Tsuboi, Nobuo, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Yamamoto, Hiroyasu, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Yokoo, Takashi, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
Background

Post-transplant anemia (PTA) is associated with the progression of kidney disease and mortality in kidney transplant recipients. In general, PTA is categorized into early and late types, commonly appearing during the two years following transplantation. Although the main causes of PTA are recipient factors, donor factors have not been fully investigated. In this study, we investigated the association of donor pathological findings with the incidence of PTA in kidney transplant recipients after 3 y (late PTA).

Methods

We conducted a retrospective cohort study at a single university hospital. A total of 50 consecutive adult recipients and donors were enrolled. To assess the structure of interstitial lesions, immunohistochemical staining of interstitial fibrosis and of fibroblasts were assessed in 0-hr biopsies for quantitative analysis.

Results

The incidence of late PTA in this cohort was 30%. Mean hemoglobin (Hb) was 11.6 ± 0.8 g/dL in patients with late PTA, and 14.3 ± 1.5 g/dL in patients without PTA. An inverse association was observed in biopsies between interstitial fibrosis area and interstitial fibroblast area (P<0.01), and each pathological finding was examined for its association with late PTA incidence after multivariate adjustment. For interstitial fibrosis area, the odds ratio (OR) was 1.94, with a 95% confidence interval (CI) of 1.26 to 2.99; P<0.01. For interstitial fibroblast area, OR was 0.01, 95% CI was 0.00 to 0.16, and P<0.01. Receiver operating characteristic curve analysis indicated that interstitial fibroblast area had high predictive power for the incidence of late PTA.

Conclusion

The presence of interstitial fibroblasts in donor kidney may play an important role in predicting the incidence of late PTA.