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Assessment of donor biopsies

Hopfer, Helmuta; Kemény, Évab

Current Opinion in Organ Transplantation: June 2013 - Volume 18 - Issue 3 - p 306–312
doi: 10.1097/MOT.0b013e3283607a6e
PATHOLOGY: Edited by Michael Mengel

Purpose of review To provide an up-to-date overview about the assessment of donor biopsies and to discuss the current problems and chances of preimplantation biopsies for transplant allocation with a focus on the technical work up and the histological variables scored.

Recent findings Preimplantation biopsy results are the major reason for discarding procured extended donor criteria kidneys in the USA. There is neither a consensus on the work up, nor the reporting of preimplantation donor biopsies, nor the importance of the biopsy findings in the process of allocation. The best available data have been collected in the context of single vs. double kidney transplantation. A clinical risk factor score may help to define kidneys when a preimplantation biopsy is warranted. Punch biopsies using a skin punch device appear to be a reasonable alternative for surgeons fearing needle biopsies.

Summary Donor biopsies are very useful as zero-hour biopsies establishing baseline information for comparison with subsequent transplant biopsies. As none of the histological variables and scores provides perfect prediction, preimplantation biopsy results have to be interpreted in the context of all available donor and recipient information.

aInstitute for Pathology, University Hospital Basel, Basel, Switzerland

bDepartment of Pathology, University of Szeged, Szeged, Hungary

Correspondence to Dr Helmut Hopfer, Institute for Pathology, University Hospital Basel, Schönbeinstrasse 40, CH-4031 Basel, Switzerland. Tel: +41 61 2652890; fax: +41 61 2653194; e-mail: Helmut.Hopfer@usb.ch

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins