Observational Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Aug 9, 2018; 8(4): 110-121
Published online Aug 9, 2018. doi: 10.5500/wjt.v8.i4.110
Renal transplants from older deceased donors: Is pre-implantation biopsy useful? A monocentric observational clinical study
Giacomo Colussi, Costanza Casati, Valeriana Giuseppina Colombo, Mario Livio Pietro Camozzi, Fabio Rosario Salerno
Giacomo Colussi, Costanza Casati, Valeriana Giuseppina Colombo, Fabio Rosario Salereno, Division of Nephrology, Dialysis and Renal Transplantatation, ASST Grande Ospedale Territoriale Niguarda, Milan 20162, Italy
Mario Livio Pietro Camozzi, Division of Pathology, ASST Grande Ospedale Territoriale Niguarda, Milan 20162, Italy
Fabio Rosario Salerno, School of Nephrology, Milano-Bicocca University, Milan 20126, Italy
Author contributions: Colussi G designed the study, wrote the draft, and contributed to data acquisition, data analysis and interpretation; Camozzi MPL, Colombo VG and Casati C contributed to data acquisition, editing, reviewing and final approval of article; Salerno FR contributed to data acquisition and data analysis.
Institutional review board statement: DKT protocol has been issued by the regional regulatory agency NITp with n. PT.(02).06.580; local ethic committee Milano Area 3 has been notified of the study as an anonymous and non-interventional report.
Informed consent statement: Each patient signed informed consent at the time of listing for renal transplantation, and before renal transplantation itself. No further informed consent was required for this study because the analysis used anonymous clinical data that were collected after patients agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Giacomo Colussi, MD, Chief Doctor, Division of Nephrology, Dialysis and Renal Transplantatation, ASST Grande Ospedale Territoriale Niguarda, Piazza Ospedale Maggiore, 3, Milan 20162,Italy. giacomo.colussi@ospedaleniguarda.it
Telephone: +39-2-64442521 Fax: +39-2-64442709
Received: February 28, 2018
Peer-review started: March 8, 2018
First decision: April 4, 2018
Revised: April 9, 2018
Accepted: May 11, 2018
Article in press: May 13, 2018
Published online: August 9, 2018
Processing time: 154 Days and 12.8 Hours
Core Tip

Core tip: Pre-implantation biopsy of grafts from elderly donors is under appraisal as a means to direct the acceptance/discard decision of organs for transplantation and the best allocation to single rather than dual transplant. Presented data shows that in recipients of grafts from older donors, rated suitable to donate according to clinical data and preserved renal function, graft and patient survival did not differ in the two categories of transplants with graft histological score in the lower (1-4) or higher (5-8) range of a scale in use. Additionally, allocation of higher score grafts to single or dual transplant did not result in different survival in time, but observed total number of dialysis free life years in recipients up to 6 years was lower for the dual kidney transplant (DKT) allocation. We suggest that older donors rated suitable to donation by clinical decision and preserved renal function may be allocated to single kidney transplant without biopsy; if biopsy is performed, higher scores than those in actual use should be considered for allocation to DKT.