Use of kidney biopsy results from deceased donor kidneys does not improve prediction of allograft survival, according to a study published in the Journal of the American Society of Nephrology. Investigators conducted a population-based study involving patients who received a deceased donor kidney that had been biopsied before implantation in France and Belgium. Kidneys that had been acquired from deceased US donors for transplantation and were discarded due to low organ quality were also studied. Adding donor histology did not significantly improve prediction of long-term allograft failure in the development cohort of 1,629 kidney recipients at two French centers. The lack of improved accuracy from adding histology was confirmed in an external validation cohort from two Belgian centers. Of 1,103 US kidneys discarded due to histologic findings, about 45% could be accurately matched to very similar kidneys that had been transplanted in France; the allograft survival rates of these discarded kidneys were expected to be 93.1%, 80.7%, and 68.9% at 1, 5, and 10 years, respectively. “These results add to a growing body of evidence that a ready opportunity exists for U.S. centers to increase the number of kidney transplants by adopting evidence-based standards for organ acceptance,” the authors write. “This report provides a strong rationale for organ procurement organizations to reduce the routine practice of obtaining biopsies of deceased donor kidneys.”
