Jens Randel Nyengaard

Human kidney graft survival correlates with structural parameters in baseline biopsies: a quantitative observational cohort study with more than 14 years' follow-up

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Human kidney graft survival correlates with structural parameters in baseline biopsies : a quantitative observational cohort study with more than 14 years' follow-up. / Ellingsen, Anne R; Jørgensen, Kaj A; Østerby, Ruth; Petersen, Steffen E; Juul, Svend; Marcussen, Niels; Nyengaard, Jens R.

In: Virchows Archiv, Vol. 478, No. 4, 04.2021, p. 659-668.

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@article{228766e1291a44ebb2036fdae1c99d6e,
title = "Human kidney graft survival correlates with structural parameters in baseline biopsies: a quantitative observational cohort study with more than 14 years' follow-up",
abstract = "This prospective cohort study evaluates associations between structural and ultrastructural parameters in baseline biopsies from human kidney transplants and long-term graft survival after more than 14 years' follow-up. Baseline kidney graft biopsies were obtained prospectively from 54 consecutive patients receiving a kidney transplant at a single institution. Quantitative measurements were performed on the baseline biopsies by computer-assisted light microscopy and electron microscopy. Stereology-based techniques estimated the fraction of interstitial tissue, the volume of glomeruli, mesangial fraction, and basement membrane thickness of glomerular capillaries. The fraction of occluded glomeruli and scores according to the Banff classification were achieved. Kidney graft survival was analyzed by Kaplan-Meier estimates and Cox regression. Association to long-term kidney function was also analyzed. The long-term surviving kidney transplants were characterized at implantation by less arteriolar hyaline thickening (P < 0.001) and less interstitial fibrosis (P = 0.001), as well as a lower fraction of occluded glomeruli (P = 0.004) and lower glomerular volume (P = 0.03). At the latest follow-up, eGFR was decreased by 12 ml/min/1.73 m2 per unit increase in the score for arteriolar hyalinosis at implantation (P = 0.02), and eGFR was decreased by 19 ml/min/1.73 m2 per 106 μm3 increase in glomerular volume at baseline (P = 0.03). The unbiased Cavalieri estimate of glomerular volume and the ultrastructural parameters are the first to be evaluated in a cohort study with prospective follow-up for more than 14 years. The study shows that baseline biopsies from human kidney grafts contain extraordinary long-term prognostic information, and it highlights the importance of these intrinsic graft factors.",
keywords = "baseline biopsy, cohort study, human kidney graft, long term, morphometry, prospective, quantification, stereology, structural parameters",
author = "Ellingsen, {Anne R} and J{\o}rgensen, {Kaj A} and Ruth {\O}sterby and Petersen, {Steffen E} and Svend Juul and Niels Marcussen and Nyengaard, {Jens R}",
year = "2021",
month = apr,
doi = "10.1007/s00428-020-02924-3",
language = "English",
volume = "478",
pages = "659--668",
journal = "Virchows Archiv",
issn = "0945-6317",
publisher = "Springer",
number = "4",

}

RIS

TY - JOUR

T1 - Human kidney graft survival correlates with structural parameters in baseline biopsies

T2 - a quantitative observational cohort study with more than 14 years' follow-up

AU - Ellingsen, Anne R

AU - Jørgensen, Kaj A

AU - Østerby, Ruth

AU - Petersen, Steffen E

AU - Juul, Svend

AU - Marcussen, Niels

AU - Nyengaard, Jens R

PY - 2021/4

Y1 - 2021/4

N2 - This prospective cohort study evaluates associations between structural and ultrastructural parameters in baseline biopsies from human kidney transplants and long-term graft survival after more than 14 years' follow-up. Baseline kidney graft biopsies were obtained prospectively from 54 consecutive patients receiving a kidney transplant at a single institution. Quantitative measurements were performed on the baseline biopsies by computer-assisted light microscopy and electron microscopy. Stereology-based techniques estimated the fraction of interstitial tissue, the volume of glomeruli, mesangial fraction, and basement membrane thickness of glomerular capillaries. The fraction of occluded glomeruli and scores according to the Banff classification were achieved. Kidney graft survival was analyzed by Kaplan-Meier estimates and Cox regression. Association to long-term kidney function was also analyzed. The long-term surviving kidney transplants were characterized at implantation by less arteriolar hyaline thickening (P < 0.001) and less interstitial fibrosis (P = 0.001), as well as a lower fraction of occluded glomeruli (P = 0.004) and lower glomerular volume (P = 0.03). At the latest follow-up, eGFR was decreased by 12 ml/min/1.73 m2 per unit increase in the score for arteriolar hyalinosis at implantation (P = 0.02), and eGFR was decreased by 19 ml/min/1.73 m2 per 106 μm3 increase in glomerular volume at baseline (P = 0.03). The unbiased Cavalieri estimate of glomerular volume and the ultrastructural parameters are the first to be evaluated in a cohort study with prospective follow-up for more than 14 years. The study shows that baseline biopsies from human kidney grafts contain extraordinary long-term prognostic information, and it highlights the importance of these intrinsic graft factors.

AB - This prospective cohort study evaluates associations between structural and ultrastructural parameters in baseline biopsies from human kidney transplants and long-term graft survival after more than 14 years' follow-up. Baseline kidney graft biopsies were obtained prospectively from 54 consecutive patients receiving a kidney transplant at a single institution. Quantitative measurements were performed on the baseline biopsies by computer-assisted light microscopy and electron microscopy. Stereology-based techniques estimated the fraction of interstitial tissue, the volume of glomeruli, mesangial fraction, and basement membrane thickness of glomerular capillaries. The fraction of occluded glomeruli and scores according to the Banff classification were achieved. Kidney graft survival was analyzed by Kaplan-Meier estimates and Cox regression. Association to long-term kidney function was also analyzed. The long-term surviving kidney transplants were characterized at implantation by less arteriolar hyaline thickening (P < 0.001) and less interstitial fibrosis (P = 0.001), as well as a lower fraction of occluded glomeruli (P = 0.004) and lower glomerular volume (P = 0.03). At the latest follow-up, eGFR was decreased by 12 ml/min/1.73 m2 per unit increase in the score for arteriolar hyalinosis at implantation (P = 0.02), and eGFR was decreased by 19 ml/min/1.73 m2 per 106 μm3 increase in glomerular volume at baseline (P = 0.03). The unbiased Cavalieri estimate of glomerular volume and the ultrastructural parameters are the first to be evaluated in a cohort study with prospective follow-up for more than 14 years. The study shows that baseline biopsies from human kidney grafts contain extraordinary long-term prognostic information, and it highlights the importance of these intrinsic graft factors.

KW - baseline biopsy

KW - cohort study

KW - human kidney graft

KW - long term

KW - morphometry

KW - prospective

KW - quantification

KW - stereology

KW - structural parameters

UR - http://www.scopus.com/inward/record.url?scp=85091614581&partnerID=8YFLogxK

U2 - 10.1007/s00428-020-02924-3

DO - 10.1007/s00428-020-02924-3

M3 - Journal article

C2 - 32986179

VL - 478

SP - 659

EP - 668

JO - Virchows Archiv

JF - Virchows Archiv

SN - 0945-6317

IS - 4

ER -