Introduction:Transplant  vasculopathy(Tv) is a confusing term that included endarteritis,atherosclerosis, and allograft arteriopathy. Kidney transplant  is a model  for the antibody-dependent and independent  immune  vascular injury. It is often more severe or “accelerated”  than expected based on the age of the donor and could lead to graft loss.The aim of this study is to evaluated  the presence of  transplant  vasculopathy  in kidney transplant  biopsies and risk factors associated.
Methods: This retrospective study  included  239 allograft  biopsies for cause  in 112 kidney transplant recipient from  2015 to  2016.  All  biopsies, with and without transplant arteriopathy, donor, recipient and transplant proper variables were  analyzed.
Statistical Analysis: All data are expressed as mean ± standard deviation or proportions, unless otherwise indicated. Considering the presence of vasculopathy as dependent variable we performed a univariate analysis with the others variables. Unpaired ‘t’ test was used for those normally distributed variables whereas the Fisher exact test was used for comparison of count variables. A a P-value ≤ 0.05 was considered statistically significant. All variables that had statistical significance were included in a multiple logistic regression model.
Results:Transplant vasculopathy was found in  55/112 patients (52.9%) Recipient age was 46 (18-75 ) years ,sixty  were  men,  41% were sensitized and 10% were hypersensitized. Donor age was  42.98 (11-72) years ,  58 males, 61(56%) were deceased donor and 11 met expanded criteria(10%). In 54.23%  cerebrovascular/stroke was the cause of death among deceased donors (CVA-Death), 15% were hypertensive and two were diabetic. Mean Ischemic time  was 19 ± 5 hours. In univariate analysis transplant vasculopathy was  correlated with donor age : 60% positive in patient >45 years  vs 35%   in patients <35 years, donor  males 59% vs 34 %  ( p<0.03.). In cadaveric donors  with vascular brain accident as death cause Transplant vasculopathy  was found  in 64.3%  of biopsies vs only in 10%  of donor  traumatic brain death(p<0.004). As regards immunological factors: in biopsies  consistent with microcirculation injury(IM) vascular injury  was present in 62.3 %vs 34% in biopsies without inflammation (p< 0.0001).In multivariate  analysis  only microvascular injury results significative.
Conclusion: In this study  risk factors  associated with develop of transplant vasculopathy in kidney allograft biopsies  were: older and male donors, vascular brain accident as  death cause and microcirculation injury in graft biopsies.