Kidney Topics

Histopathological analysis of pre-implantation donor kidney biopsy: redefining the role in the process of graft assessment (Part 1)

Preimplantation biopsy provides a window on the state of the renal allograft, and it is a valuable decision-making tool in transplantation (mainly in programs from deceased ECD or high risk recovered donors).

However, although the clinical utility of this procedure is well reported, its introduction in daily clinical practice is still debated and poorly standardised. Currently, there is no consensus about several biopsy-related technical issues and the real impact of histopathological alterations in kidney compartments as a prognostic factor in graft survival and function is not well defined. Finally, the employment of this practice in DCD and the impact of the histological lesions in this clinical setting should be better defined and discussed.

Topic Chairs: Lucrezia Furian & Gianluigi Zaza

Topic Steering Committee: Aiko de Vries, David Cucchiari, Lorna Marson, Michele Rossini, Jan Becker, Albino Eccher, Sandrine Florquins, Jesper Kers, Marion Rabant

The value of monitoring (subclinical) donor specific antibodies (DSAs) for kidney transplant outcomes

DSAs are associated with antibody mediated casu quo chronic rejection and poor outcome. The value of a DSA as biomarker for ABMR diagnosis from an indication biopsy (increased creatinine and proteinuria) seems clear. However, the value of subclinical DSAs (without increase in serum creatinine or proteinuria) is less clear.

Subclinical DSAs are thought be an early biomarker of nonadherence or rejection but may also be transient around other clinical issues. The merit of detecting early rejection from routine DSA monitoring is uncertain, as are potential treatment options and change in prognosis. Subsequently, there is clinical practice variation in routine monitoring of DSAs.

Topic Chair: Aiko de Vries

Topic Steering Committee: Marie Paule Emonds, Soufian Meziyerh, Emanuele Cozzi, Dominique Bertrand, Dennis van den Broek, Klemens Budde, Anthony Dorling, Covadonga López del Moral