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. 2025 Oct;39(10):e70332.
doi: 10.1111/ctr.70332.

Baseline Vascular Pathology in Deceased Donor Kidneys: Differential Impact on Transplant Outcomes by Donor Type

Junichiro Sageshima  1 , Naeem Goussous  1 , Yvonne Kelly  1 , Caitlin Loseth  1 , Karima Alghannam  1 , Ling-Xin Chen  2 , Lea Matsuoka  1 , Sophoclis Alexopoulos  1 , Richard Perez  1 , Kuang-Yu Jen  3
Affiliations

Baseline Vascular Pathology in Deceased Donor Kidneys: Differential Impact on Transplant Outcomes by Donor Type

Junichiro Sageshima et al. Clin Transplant. 2025 Oct.

Abstract

Background: The impact of kidney vascular pathology on transplant outcomes remains poorly understood, particularly under specific donor conditions.

Methods: This retrospective single-center study analyzed 837 deceased donor kidney transplants. Based on baseline vascular histology, the kidneys were categorized into two groups: minimal vascular disease (Group 0, n = 637) and significant vascular disease (Group 1, n = 200). Five-year graft survival and 6- and 12-month kidney function were evaluated, along with subgroup analyses of various donor characteristics. Propensity score matching was used to adjust for confounding factors.

Results: Recipients of kidneys with significant vascular disease showed worse 5-year overall graft survival (64.6% vs. 80.0%, p = 0.0002) and death-censored graft survival (85.6% vs. 91.5%, p = 0.0126). These differences persisted after propensity score matching. The impact was most pronounced in hypertensive donors (53.4% vs. 84.9%) and diabetic donors (52.3% vs. 69.0%). Circulatory death donors showed immediate adverse effects, while brain death donors demonstrated delayed deterioration. Kidneys with significant vascular disease exhibited lower glomerular filtration rates at follow-up.

Conclusion: Baseline vascular disease in deceased donor kidneys has a significant impact on transplant outcomes, independent of clinical risk factors. These findings support the incorporation of vascular histological assessment into donor evaluation to enhance risk stratification and optimize post-transplant management.

Keywords: biopsy; deceased donors; kidney transplantation; transplantation outcomes; vascular diseases.

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References

    1. P. Jadav, S. Mohan, and S. A. Husain, “Role of Deceased Donor Kidney Procurement Biopsies in Organ Allocation,” Current Opinion in Nephrology and Hypertension 30, no. 6 (2021): 571–576, https://doi.org/10.1097/MNH.0000000000000746.
    1. C. J. Wang, J. B. Wetmore, G. S. Crary, and B. L. Kasiske, “The Donor Kidney Biopsy and Its Implications in Predicting Graft Outcomes: A Systematic Review,” American Journal of Transplantation 15, no. 7 (2015): 1903–1914, https://doi.org/10.1111/ajt.13213.
    1. S. M. Cockfield, R. B. Moore, G. Todd, K. Solez, and S. Gourishankar, “The Prognostic Utility of Deceased Donor Implantation Biopsy in Determining Function and Graft Survival After Kidney Transplantation,” Transplantation 89, no. 5 (2010): 559–566, https://doi.org/10.1097/TP.0b013e3181ca7e9b.
    1. E. Pokorna, S. Vitko, M. Chadimova, and O. Schuck, “Adverse Effect of Donor Arteriolosclerosis On Graft Outcome After Renal Transplantation,” Nephrology, Dialysis, Transplantation 15, no. 5 (2000): 705–710, https://doi.org/10.1093/ndt/15.5.705.
    1. L. K. Kayler, R. Mohanka, A. Basu, R. Shapiro, and P. S. Randhawa, “Correlation of Histologic Findings on Preimplant Biopsy With Kidney Graft Survival,” Transplant International 21, no. 9 (2008): 892–898, https://doi.org/10.1111/j.1432‐2277.2008.00681.x.

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