Assessment of kidney organ quality and prediction of outcome at time of transplantation

Thomas F. Mueller, Kim Solez, Valeria Mas

Research output: Contribution to journalReview article

26 Citations (Scopus)

Abstract

The critical importance of donor organ quality, i.e., number of surviving nephrons, ability to withstand injury, and capacity for repair in determining short- and long-term outcomes is becoming increasingly clear. This review provides an overview of studies to assess donor kidney quality and subsequent transplant outcomes based on clinical pathology and transcriptome-based variables available at time of transplantation. Prediction scores using clinical variables function when applied to large data sets but perform poorly for the individual patient. Histopathology findings in pre-implantation or post-reperfusion biopsies help to assess structural integrity of the donor kidney, provide information on pre-existing donor disease, and can serve as a baseline for tracking changes over time. However, more validated approaches of analysis and prospective studies are needed to reduce the number of discarded organs, improve allocation, and allow prediction of outcomes. Molecular profiling detects changes not seen by morphology or captured by clinical markers. In particular, molecular profiles provide a quantitative measurement of inflammatory burden or immune activation and reflect coordinated changes in pathways associated with injury and repair. However, description of transcriptome patterns is not an end in itself. The identification of predictive gene sets and the application to an individualized patient management needs the integration of clinical and pathology-based variables, as well as more objective reference markers of transplant function, post-transplant events, and long-term outcomes.

Original languageEnglish (US)
Pages (from-to)185-199
Number of pages15
JournalSeminars in Immunopathology
Volume33
Issue number2
DOIs
StatePublished - Mar 1 2011
Externally publishedYes

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Transplantation
Tissue Donors
Kidney
Clinical Pathology
Transplants
Transcriptome
Preexisting Condition Coverage
Nephrons
Wounds and Injuries
Reperfusion
Biomarkers
Prospective Studies
Biopsy
Genes

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology

Cite this

Assessment of kidney organ quality and prediction of outcome at time of transplantation. / Mueller, Thomas F.; Solez, Kim; Mas, Valeria.

In: Seminars in Immunopathology, Vol. 33, No. 2, 01.03.2011, p. 185-199.

Research output: Contribution to journalReview article

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