A recent review in Nature Nephrology discuses this important concept. A large study out of Finland is discussed in this review and how the donor risk score was developed. What they describe is a donor allograft damage index which involves clinical components as well pathology components.
What constitutes the clinical components are: age >50, smoking, unstable blood pressure, HTN, need for CPR, alcohol abuse, untreated HTN, ischemic heart disease, arteriosclerosis, oliguria and the biopsy component is vascular intimal sclerosis, tubular atrophy, interstitial fibrosis, interstitial inflammation, mesangial matrix increase and glomerulosclerosis. The Biopsies of the donors were graded with a 0-3 point system with each of the six histological criteria and the higher the points- the worse the kidney was. The authors showed that the presence of >5 risk factors(clinical) and associated with an increase in mean allograft damage score from 0.5 to 1.4 and an increase in percent glomerulosclerosis from 1.5% to 8.1%. And eventually higher donor risk scores were associated with long term graft outcomes over 5 years as well.
One of the few large studies to look at histological allograft data and comparing that to the clinical data. Interesting to see what comes next.
- ► 2019 (42)
- ► 2018 (57)
- ► 2017 (52)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- ► 2013 (133)
- ► 2012 (201)
- TOPIC DISCUSSION: The return of "Spironolactone"
- Match the drugs with the toxicity game!
- CLINICAL CASE and ANSWERS 38
- TOPIC DISCUSSION: Clinical Pearls for electrolytes!
- TOPIC DISCUSSION: Origins of the 1.73m2 in the GFR...
- Prolia or Xgeva, Denosumab and The Renal world!
- Alemtuzumab for Induction- the 2011 update
- TOPIC DISCUSSION: Hibernating Bear's urine?
- CONSULT ROUNDS: Ethylene Glycol Toxicity
- Asian Dialysis Modality Survey by Pediatric Nephro...
- Check out this website
- Tumor Lysis Syndrome
- Medicine for residents: Elevated pulse pressure an...
- TOPIC DISCUSSION: Micro Rnas and Chronic Kidney Di...
- Nephrology Crosswords- Pediatric Nephrology
- NKF 2011 Recap- Rhabdomyolysis as the theme
- Donor Risk Scores?
- CLINICAL CASE 37, ANSWERS AND SUMMARY
- "Brain Drain" in nephrology
- TOPIC DISCUSSION: The Distal Hypoperfusion Ischemi...
- Nephrology Fellow Career Choice Satisfaction Survey
- Dual Live Transplants performed
- Interesting Urine Lytes
- NKF 2011 Live: First Clinical Guidelines on Acute ...
- CLINICAL CASE 36, ANSWERS AND SUMMARY
- IN THE NEWS- Hyponatremia and Mortality( its the u...
- ▼ May (26)
- ► 2010 (461)