The Puzzle of Preimplantation Kidney Biopsy Decision-Making Process: The Pathologist Perspective

Kidney transplantation is the best treatment for end-stage renal disease since it offers the greatest survival benefit compared to dialysis. The gap between the number of renal transplants performed and the number of patients awaiting renal transplants leads to a steadily increasing pressure on the...

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Published inLife (Basel, Switzerland) Vol. 14; no. 2; p. 254
Main Authors Eccher, Albino, Becker, Jan Ulrich, Pagni, Fabio, Cazzaniga, Giorgio, Rossi, Mattia, Gambaro, Giovanni, L'Imperio, Vincenzo, Marletta, Stefano
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 01.02.2024
Subjects
Analysis
Artificial intelligence
Biopsy
Care and treatment
Chronic kidney failure
Clinical medicine
Cost control
Creatinine
Decision making
Dialysis
Education
End-stage renal disease
Kidney diseases
kidney transplant
Kidney transplantation
Kidney transplants
Kidneys
Laboratories
Medical personnel
Methods
pathologist
Pathologists
Pathology
Practice
Prediction models
preimplantation kidney biopsy
Preoperative care
Professionals
Simulation
Skills
Survival
Transplantation
Transplants
Italy
kidney transplant
pathologist
preimplantation kidney biopsy
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Summary:Kidney transplantation is the best treatment for end-stage renal disease since it offers the greatest survival benefit compared to dialysis. The gap between the number of renal transplants performed and the number of patients awaiting renal transplants leads to a steadily increasing pressure on the scientific community. Kidney preimplantation biopsy is used as a component of the evaluation of organ quality before acceptance for transplantation. However, the reliability and predictive value of biopsy data are controversial. Most of the previously proposed predictive models were not associated with graft survival, but what has to be reaffirmed is that histologic examination of kidney tissue can provide an objective window on the state of the organ that cannot be deduced from clinical records and renal functional studies. The balance of evidence indicates that reliable decisions about donor suitability must be made based on the overall picture. This work discusses recent trends that can reduce diagnostic timing and variability among players in the decision-making process that lead to kidney transplants, from the pathologist's perspective.
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ISSN:2075-1729
2075-1729
DOI:10.3390/life14020254