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Abstract: PO2199

The Histological Fingerprint of Kidney from High Kidney Donor Profile Index Diabetic Donors Transplanted in Non-Diabetic Recipients

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Comai, Giorgia, 1) Nephrology, Dialysis and Kidney Transplantation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
  • Corradetti, Valeria, 1) Nephrology, Dialysis and Kidney Transplantation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
  • Maritati, Federica, 1) Nephrology, Dialysis and Kidney Transplantation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
  • Bini, Claudia, 1) Nephrology, Dialysis and Kidney Transplantation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
  • Busutti, Marco, 1) Nephrology, Dialysis and Kidney Transplantation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
  • La Manna, Gaetano, 1) Nephrology, Dialysis and Kidney Transplantation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Background

To face the persistent organ shortage and the increasing age and comorbidities of donors, criteria to donation have been expanded. Diabetic donors are recognized as a reliable source of organ, few data are available on the histological evolution of these organs for these reasons we compare the pre implantation biopsy of high-KDPI diabetic donor with a protocol biopsy of non diabetic recipients.

Methods

We performed a retrospective analysis of deceased donors from 2004 to 2015. We selected those with a diagnosis of diabetes and with available pre implantation kidney biopsy (T0) that was scored for diabetic and Karspinski score. Then we selected those recipients whose at time of analysis (T1) were still on follow up, had not a history of diabetes and executed at least one biopsy which has been compared with the previous one.

Results

A total of 10 cadaveric kidney donors (mean KDPI 95.7%) were selected. Diabetic lesions of all classes present already at pre-implantation biopsies associated with mild IF/TA and vascular damages. At follow-up the lesions showed variable modifications of DN class (fig.1) and
moderate evolution of IF/TA and vascular damages. eGFRs were stable and proteinuria was mild.

Conclusion

In the ten patients and at the different follow-ups there was not a uniform trend of DN lesions, we demonstrated an amelioration in 3 cases, stability in 4 and worsening in 3, and did not find a relationship between these changes and the follow up time.
Our data suggest that the diabetic kidneys keep after transplantation the histologic stigma that denote their origin and
even in this very marginal extended criteria donation the diabetes status in the donor may not represent a limitation to transplantation in favorable conditions as euglycemia.