Aggravation of fibrin deposition and microthrombus formation within the graft during kidney transplantation

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Abstract

In kidney transplantation, microthrombi and fibrin deposition may lead to local perfusion disorders and subsequently poor initial graft function. Microthrombi are often regarded as donor-derived. However, the incidence, time of development, and potential difference between living donor kidneys (LDK) and deceased donor kidneys(DDK), remains unclear. Two open-needle biopsies, taken at preimplantation and after reperfusion, were obtained from 17 LDK and 28 DDK transplanted between 2005 and 2008. Paraffin-embedded sections were immunohistochemically stained with anti-fibrinogen antibody. Fibrin deposition intensity in peritubular capillaries(PTC) and glomeruli was categorized as negative, weak, moderate or strong and the number of microthrombi/mm2 was quantified. Reperfusion biopsies showed more fibrin deposition (20% to 100% moderate/strong, p < 0.001) and more microthrombi/mm2 (0.97 ± 1.12 vs. 0.28 ± 0.53, p < 0.01) than preimplantation biopsies. In addition, more microthrombi/mm2 (0.38 ± 0.61 vs. 0.09 ± 0.22, p = 0.02) and stronger fibrin intensity in glomeruli (28% vs. 0%, p < 0.01) and PTC (14% vs. 0%, p = 0.02) were observed in preimplantation DDK than LDK biopsies. After reperfusion, microthrombi/mm2 were comparable (p = 0.23) for LDK (0.09 ± 0.22 to 0.76 ± 0.49, p = 0.03) and DDK (0.38 ± 0.61 to 0.90 ± 1.11, p = 0.07). Upon reperfusion, there is an aggravation of microthrombus formation and fibrin deposition within the graft. The prominent increase of microthrombi in LDK indicates that they are not merely donor-derived.
Original languageEnglish
Article number18937
Pages (from-to)18937
Number of pages11
JournalScientific Reports
Volume11
Issue number1
DOIs
Publication statusPublished - 23-Sep-2021

Keywords

  • Adult
  • Allografts/blood supply
  • Biopsy
  • Female
  • Fibrin/analysis
  • Graft Survival
  • Heparin/administration & dosage
  • Humans
  • Intraoperative Care/methods
  • Kidney Glomerulus/blood supply
  • Kidney Transplantation/adverse effects
  • Living Donors/statistics & numerical data
  • Male
  • Middle Aged
  • Observational Studies as Topic
  • Postoperative Complications/diagnosis
  • Prospective Studies
  • Thrombosis/diagnosis
  • Transplantation, Homologous/adverse effects

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