Value of original and modified pathological scoring systems for prognostic prediction in paraffin-embedded donor kidney core biopsy
Background No study has validated, compared and adapted scoring systems for prognosis prediction based on donor kidney core biopsy (CB), with less glomeruli than wedge biopsy.Methods A total of 185 donor kidney CB specimens were reviewed using seven scoring systems. The association between the total...
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Taylor & Francis Group
2024-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2314630 |
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| author | Jinghong Tan Huanxi Zhang Longshan Liu Jun Li Qian Fu Yan Li Chenglin Wu Ronghai Deng Jiali Wang Bowen Xu Wenfang Chen Shicong Yang Changxi Wang |
| author_facet | Jinghong Tan Huanxi Zhang Longshan Liu Jun Li Qian Fu Yan Li Chenglin Wu Ronghai Deng Jiali Wang Bowen Xu Wenfang Chen Shicong Yang Changxi Wang |
| author_sort | Jinghong Tan |
| collection | DOAJ |
| description | Background No study has validated, compared and adapted scoring systems for prognosis prediction based on donor kidney core biopsy (CB), with less glomeruli than wedge biopsy.Methods A total of 185 donor kidney CB specimens were reviewed using seven scoring systems. The association between the total score, item scores, score-based grading, and allograft prognosis was investigated. In specimens with less than ten glomeruli (88/185, 47.6%), scoring systems were modified by adjusting weights of the item scores.Results The Maryland aggregate pathology index (MAPI) score-based grading and periglomerular fibrosis (PGF) associated with delayed graft function (DGF) (Grade: OR = 1.59, p < 0.001; PGF: OR = 1.06, p = 0.006). Total score, score-based grading and chronic lesion score in scoring systems associated with one-year and 3-year eGFR after transplantation. Total-score-based models had similar predictive capacities for eGFR in all scoring systems, except MAPI and Ugarte. Score of glomerulosclerosis (GS), interstitial fibrosis (IF), tubular atrophy (TA), and arteriolar hyalinosis (AH) had good eGFR predictive capacities. In specimens with less than ten glomeruli, modified scoring systems had better eGFR predictive capacities than original scoring systems.Conclusions Scoring systems could predict allograft prognosis in paraffin-embedded CB with ten more glomeruli. A simple and pragmatic scoring system should include GS, IF, TA and AH, with weights assigned based on predictive capacity for prognosis. Replacing GS scores with tubulointerstitial scores could significantly improve the predictive capacity of eGFR. The conclusion should be further validated in frozen section. |
| format | Article |
| id | doaj-art-bd0d0c29c7f842998970833104fafeb6 |
| institution | Kabale University |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj-art-bd0d0c29c7f842998970833104fafeb62025-01-23T04:17:49ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146110.1080/0886022X.2024.2314630Value of original and modified pathological scoring systems for prognostic prediction in paraffin-embedded donor kidney core biopsyJinghong Tan0Huanxi Zhang1Longshan Liu2Jun Li3Qian Fu4Yan Li5Chenglin Wu6Ronghai Deng7Jiali Wang8Bowen Xu9Wenfang Chen10Shicong Yang11Changxi Wang12Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaBackground No study has validated, compared and adapted scoring systems for prognosis prediction based on donor kidney core biopsy (CB), with less glomeruli than wedge biopsy.Methods A total of 185 donor kidney CB specimens were reviewed using seven scoring systems. The association between the total score, item scores, score-based grading, and allograft prognosis was investigated. In specimens with less than ten glomeruli (88/185, 47.6%), scoring systems were modified by adjusting weights of the item scores.Results The Maryland aggregate pathology index (MAPI) score-based grading and periglomerular fibrosis (PGF) associated with delayed graft function (DGF) (Grade: OR = 1.59, p < 0.001; PGF: OR = 1.06, p = 0.006). Total score, score-based grading and chronic lesion score in scoring systems associated with one-year and 3-year eGFR after transplantation. Total-score-based models had similar predictive capacities for eGFR in all scoring systems, except MAPI and Ugarte. Score of glomerulosclerosis (GS), interstitial fibrosis (IF), tubular atrophy (TA), and arteriolar hyalinosis (AH) had good eGFR predictive capacities. In specimens with less than ten glomeruli, modified scoring systems had better eGFR predictive capacities than original scoring systems.Conclusions Scoring systems could predict allograft prognosis in paraffin-embedded CB with ten more glomeruli. A simple and pragmatic scoring system should include GS, IF, TA and AH, with weights assigned based on predictive capacity for prognosis. Replacing GS scores with tubulointerstitial scores could significantly improve the predictive capacity of eGFR. The conclusion should be further validated in frozen section.https://www.tandfonline.com/doi/10.1080/0886022X.2024.2314630Kidney transplantationpretransplant donor kidney biopsycore biopsypathologyglomerulosclerosiseGFR |
| spellingShingle | Jinghong Tan Huanxi Zhang Longshan Liu Jun Li Qian Fu Yan Li Chenglin Wu Ronghai Deng Jiali Wang Bowen Xu Wenfang Chen Shicong Yang Changxi Wang Value of original and modified pathological scoring systems for prognostic prediction in paraffin-embedded donor kidney core biopsy Renal Failure Kidney transplantation pretransplant donor kidney biopsy core biopsy pathology glomerulosclerosis eGFR |
| title | Value of original and modified pathological scoring systems for prognostic prediction in paraffin-embedded donor kidney core biopsy |
| title_full | Value of original and modified pathological scoring systems for prognostic prediction in paraffin-embedded donor kidney core biopsy |
| title_fullStr | Value of original and modified pathological scoring systems for prognostic prediction in paraffin-embedded donor kidney core biopsy |
| title_full_unstemmed | Value of original and modified pathological scoring systems for prognostic prediction in paraffin-embedded donor kidney core biopsy |
| title_short | Value of original and modified pathological scoring systems for prognostic prediction in paraffin-embedded donor kidney core biopsy |
| title_sort | value of original and modified pathological scoring systems for prognostic prediction in paraffin embedded donor kidney core biopsy |
| topic | Kidney transplantation pretransplant donor kidney biopsy core biopsy pathology glomerulosclerosis eGFR |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2314630 |
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