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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Biopsy, Child, Child, Preschool, Fibrosis, Graft Survival, Humans, Kidney, Kidney Diseases, Kidney Transplantation, Middle Aged, Time Factors, Transplantation, Homologous.
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Does fibrous intimal thickening at implantation adversely affect long-term kidney allograft function? Context: Kidneys from marginal and older donors are increasingly used to respond to the increasing demand for kidney transplants. This study evaluated the predictive value of intimal hyperplasia, as a marker of vasculopathy, in the renal allograft at the time of transplantation (transplantation) on the subsequent graft function (7 years). The intima/media ratio of the arterial walls (I/M) was morphometrically determined by the sectorial elliptic method, in 51 implantation biopsies. Two study groups were determined. Group 1, with I/M less than or equal to 0.47, was considered as the group with minimal vascular damage at transplantation. Group 2, with I/M more than 0.47, was considered as having vasculopathy at transplantation. During the first 15 months, the estimated glomerular filtration rate improved in group 1 from 53+/-17 to 61+/-17 mL/min/1.73 m2, whereas it decreased from 51+/-21 to 46+/-14 mL/min/1.73 m2 in group 2. From 1 year posttransplantation, the estimated glomerular filtration rate (eGFR) was significantly higher in group 1 at all time points (6 month evaluation). The difference in graft function between the two groups (mean, 11 mL/min/1.73 m2) remained unchanged between 1 and 7 years posttransplantation. Among several clinical parameters investigated, blood pressure of the recipient significantly modulates the impact of preexisting vasculopathy on graft function.
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Our data provide evidence that donor-related vasculopathy, at the time of transplantation, has a persistent significant impact on the subsequent graft function. This effect becomes only apparent at 1 year posttransplantation and is increased in recipients with inadequately controlled blood pressure. Final Decision: yes