Correlation Between Frozen Section Pathological Score Of Zero Point Biopsy Of Donor Kidney And Functional Recovery Of Transplanted Kidney

Objective:To analyze the correlation between Remuzzi score and MAPI score of time-zero renal biopsy and graft function after kidney transplantation,and to explore the significance of pathological score of donor kidney in the evaluation of organ donation after citizen’s death.Methods:The data of 251 DCD donors and recipients who underwent zero point biopsy in the First Hospital of Jilin University between January 2019 and December 2020 were retrospectively analyzed.The incidence of delayed graft function(DGF)and the estimated glomerular filtration rate(e GFR)at 7 days,30 days,90 days,180 days as well as one year after operation were observed.The correlation between pathological score of donor kidney and postoperative clinical indexes was statistically analyzed.Result:A total of 251 DCD renal transplant recipients were included in this study,of which 59cases(23.5%)experienced delayed graft function.Binary logistic regression analysis showed that there was a significant correlation between the Remuzzi score of donor kidney pathology and the occurrence of DGF after operation.Every 1 point increase in Remuzzi score would increase the probability of delayed graft function by about 0.7 times(P = 0.005,OR 0.730,95% CI 0.586-0.909),but there was no significant correlation between the pathological score of donor kidney and the occurrence of DGF(P = 0.104,OR 0.903,95%CI 0.798-1.021).Further analysis found that there was a significant negative correlation between the pathological Remuzzi score and estimated glomerular filtration rate at 7 days,1 month,3months,6 months and 1 year after operation(P = 0.003,r =-0.187;P = 0.000,r =-0.249;P= 0.009,r =-0.168;P = 0.000,r =-0.305;P = 0.000,r =-0.374,respectively).However,there was no significant correlation between the pathological MAPI score of donor kidney and the estimated glomerular filtration rate at 7 days,1 month,3 months or 6 months after transplantation(P = 0.720;P = 0.105;P = 0.073;P = 0.079,respectively),but only a significant negative correlation with the estimated glomerular filtration rate at 1 year after transplantation(P = 0.002,r =-0.276).Conclusion:(1)The Remuzzi score of donor kidney has significant clinical value in predicting the delayed graft function as well as graft function after renal transplantation.(2)There is a certain clinical value in predicting the renal function one year after renal transplantation with the donor kidney’s MAPI score.