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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Kidney Transplant II: Surgical Procedure01:26

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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Kidney Structure01:45

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The kidneys are two large bean-shaped organs located in the upper abdomen. They filter the blood several times a day to remove toxins and rebalance water and electrolytes of the circulatory system via the renal veins. The kidneys receive blood directly from the heart via the renal arteries. These arteries enter the kidney at the hilum, the concave surface of the bean, where they branch and divide into smaller vessels and capillaries.
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External Anatomy of the Kidney01:21

External Anatomy of the Kidney

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The kidneys are a pair of bean-shaped organs in the human body that play a critical role in maintaining overall health. They filter out waste products from the blood, regulate blood pressure, maintain electrolyte balance, and stimulate the production of red blood cells.
The kidneys are located in the retroperitoneal space on either side of the vertebral column, protected posteriorly by the 11th and 12th ribs. The right kidney sits slightly lower than the left owing to the presence of the liver...
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Internal Anatomy of the Kidney01:12

Internal Anatomy of the Kidney

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The kidneys are essential organs in the human body, performing a myriad of tasks that maintain homeostasis and overall health.
Anatomical Position and Dimensions
The kidneys are retroperitoneal organs positioned against the posterior abdominal wall on either side of the spine, roughly between the twelfth thoracic and third lumbar vertebrae. Each kidney is typically 10-12 cm long, 5-6 cm wide, and 3-4 cm thick, weighing about 150 grams.
Renal Cortex
The outermost region of the kidney is the...
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Making Procurement Biopsies Important Again for Kidney Transplant Allocation.

Andrea Angeletti1, Paolo Cravedi2

  • 1Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Nephron
|April 2, 2019
PubMed
Summary

Procurement kidney biopsies are unreliable for predicting transplant success and may lead to unnecessary organ discards. Reperfusion biopsies offer a more accurate assessment for graft survival, highlighting a need to re-evaluate current organ allocation strategies.

Keywords:
Core-needle biopsyFrozen sectionKidney donor profile indexKidney donor risk indexKidney transplantationPretransplant donor biopsyWedge biopsy

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Area of Science:

  • Nephrology
  • Transplantation
  • Pathology

Background:

  • Procurement biopsies are crucial for evaluating deceased donor kidneys, particularly those from older donors or those with comorbidities.
  • Current criteria for performing, processing, and scoring procurement graft biopsies lack standardization.
  • Kidney allograft discard decisions are frequently influenced by procurement biopsy results.

Purpose of the Study:

  • To compare the reliability and predictive value of procurement kidney biopsies versus reperfusion biopsies for graft survival.
  • To assess the reproducibility of procurement biopsy scoring.
  • To evaluate the association of biopsy scores with transplant outcomes.

Main Methods:

  • A retrospective, single-center study analyzed 270 frozen procurement kidney sections and 270 paraffin-embedded reperfusion sections.
  • Procurement biopsy reproducibility was tested using repeated biopsies in 116 kidneys.
  • Biopsy scores were correlated with graft survival outcomes.

Main Results:

  • Procurement biopsies demonstrated poor reproducibility and did not correlate with reperfusion biopsy scores.
  • Procurement biopsy scores were not significantly associated with transplant outcomes.
  • Reperfusion biopsies accurately predicted graft survival.

Conclusions:

  • Procurement biopsies have high resource requirements and are associated with kidney discards, prompting a need to re-examine their role in organ allocation.
  • Reperfusion biopsies provide a more reliable assessment of kidney graft viability and predict survival.
  • Further studies are needed to optimize procurement biopsy assessment strategies for improved organ allocation.