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Tubular Cell Senescence in the Donated Kidney Predicts Allograft Function in Kidney Transplantation.

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eMediNexus    02 January 2018

A new study published in the American Journal of Nephrology assessed the association of tubular cell senescence with allograft and remnant kidney function. In this prospective observational clinical study, 38 living donor kidney transplantations were analyzed. Tissue sections obtained from preimplantation kidney biopsies were immunostained for p16INK4a to indicate cell senescence. The results showed that 21 donors had marginal factors, while severe tubular senescence was observed in living donors with overlapping marginal criteria. In addition, tubular senescence in living donor kidneys was notably related to donors’ age and lower recipient kidney function at 1 year after transplantation, independent of donor’s age; but did not affect remnant kidney function after donation. However, pre-transplantation, donor’s estimated glomerular filtration rate and hypertension did not show a significant area under the curve (AUC) for prediction of high tubular senescence. Whereas, high plasma levels of soluble αKlotho were associated with a higher predictive value for low tubular cell senescence with an AUC of 0.78. Thus, it was concluded that the nuclear p16-staining rate in donated kidney tubules is a predictor for allograft kidney function but not donor remnant kidney function. It was stated that detection of tubular cell senescence may facilitate selection of appropriate living donor candidates.

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