A Yale-led team of researchers is urging caution when basing kidney transplant decisions on the results of pre-surgical biopsy.
In a study that appears in the Clinical Journal of the American Society of Nephrology, the researchers found that biopsies of donated kidneys for signs of acute injury were not necessarily an accurate indicator of the suitability of an organ for transplant.
The authors wrote that the influence of acute kidney injury on a transplant is poorly understood. They biopsied more than 600 transplanted kidneys in a multicenter study, searching for associations between biopsy reports of kidney injury and eventual graft success or failure.
Except in very high-risk patients, the authors found no significant correlation between the level of organ injury and success or failure of the graft to justify making a judgment call before surgery. They authors also found that kidney injury was underreported in the biopsies, adding to the unreliability of this method of evaluation.
“Biopsies are listed as the primary reasons for discarding deceased-donor kidneys,” said senior author Dr. Chirag Parikh, director of the Program of Applied Translational Research and associate professor of nephrology at Yale School of Medicine and the Veterans Affairs Medical Center.
“However,” he added, “the current practice of kidney biopsy provides little utility for determining the overall risk of delayed organ function or even premature organ failure. We hope that future studies identify better non-invasive methods to expeditiously quantify acute and chronic kidney injury.”
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