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J Am Soc Nephrol 10:2006-2013, 1999
© 1999 American Society of Nephrology

REGULAR ARTICLES

Apoptosis of Tubular Epithelial Cells in Donor Kidney Biopsies Predicts Early Renal Allograft Function

RAINER OBERBAUER*, MANUELA ROHRMOSER*, HEINZ REGELE{dagger}, FERDINAND MÜHLBACHER{ddagger} and GERT MAYER*

* Department of Internal Medicine III, Division of Nephrology and Dialysis, University of Vienna, Vienna, Austria.
{dagger} Department of Ultrastructural Pathology, University of Vienna, Vienna, Austria.
{ddagger} Department of Transplant Surgery, University of Vienna, Vienna, Austria.

Correspondence to Dr. Rainer Oberbauer, Klinik für Innere Medizin III, Abteilung für Nephrologie und Dialyse, Währinger Gürtel 18-20, A-1090 Vienna, Austria. Phone: +43 1 40400 4390; Fax: +43 1 40400 4392; E-mail: rainer.oberbauer{at}akh-wien.ac.at

Abstract

Abstract. Acute renal failure (ARF) is a serious complication in the early postoperative period after kidney transplantation. In an effort to identify subjects at risk, several donor-, recipient-, and procedure-related factors have been studied. Because no morphologic parameter predictive of delayed graft function has been identified to date, this study was conducted to determine whether the number of apoptotic cells in donor biopsies obtained before engraftment is predictive of the development of posttransplant ARF. Donor biopsies of patients with "biopsyproven" acute tubular damage but no signs of rejection (n = 23) showed significantly higher counts of apoptotic tubular epithelial cells when compared to patients with immediate transplant function (n = 44) or early rejection (n = 22). In all groups, a significantly higher percentage of apoptotic cells was found in the distal compared to the proximal tubule. The expression of bcl-2 and proliferating cell nuclear antigen was not different among the groups. Late allograft function was not affected by early ARF as serum creatinine values were similar in all three groups after 6 mo. These data suggest that the number of apoptotic renal tubular epithelial cells in donor biopsies before engraftment is predictive of the early postoperative course in patients undergoing kidney transplantation.




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