Kidney Week

Abstract: TH-PO789

Relationship between Parenchymal Stiffness and Kidney Fibrosis in Kidney Transplant Recipients

Session Information

• Transplantation: Clinical - 2
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Unagami, Kohei, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan

Kohei Unagami, MD, PhD

• Saitoh, Ayaka, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan

Ayaka Saitoh, DrMed, DrPH

• Hirai, Toshihito, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan

Toshihito Hirai

• Omoto, Kazuya, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan

Kazuya Omoto, MD, PhD

• Shimizu, Tomokazu, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan

Tomokazu Shimizu, MD, PhD

• Hoshino, Junichi, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan

Junichi Hoshino, MD, PhD, MPH

• Takagi, Toshio, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan

Toshio Takagi

• Ishida, Hideki, Tokyo Joshi Ika Daigaku, Shinjuku-ku, Tokyo, Japan

Hideki Ishida, MD, PhD

Background

Transplant kidney biopsy has been the method for evaluating interstitial fibrosis and tubular atrophy (IF/TA) of renal allografts. However, its invasiveness, limited sequency and quantitation are shortcomings. Transient elastography (TE) is a device primarily used for measuring liver cirrhosis under ultrasound. TE may have shown promise for assessing transplanted kidney located in the iliac fossa unlike own kidneys, which are located deep from the body surface. We investigated the parenchymal stiffness of renal allografts in kidney transplant recipients and its correlation with renal allograft fibrosis and renal function.

Methods

A total of 455 recipients who underwent kidney transplantation between 2001 and 2023 were included in this study. All recipients underwent TE using FibroScan®expert630 (Echosense Paris, France) (Figure1). TE measured parenchymal stiffness in a volume approximating a cylinder of 25-55 mm in length.

Results

Parenchymal stiffness measurement was successful in 450 of 455 patients (98.9%). The median stiffness of renal allograft parenchyma was 46.7 kPa. Correlations with TE median values, recipients’ serum creatinine levels, eGFR, and IFTA showed statistically significant differences (p <0.01 in each). Further division into two groups (eGFR >40 and ≦40) revealed significant differences in allograft kidney age, renal allograft parenchyma, and recipients’ hemoglobin levels (p <0.01).

Conclusion

Renal function deterioration and IF/TA progression exhibited a robust correlation with renal allograft parenchyma by TE. TE is non-invasive, exhibits excellent reproducibility and rapidity, and is considered highly valuable for quantitative evaluation of IF/TA.

Funding

• Private Foundation Support