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Table 3 Perfusion grade after retrieval (1–4), ex-vivo normothermic perfusion (EVNP) score, remuzzi score and level of acute tubular injury (ATI)

From: The use of ex-vivo normothermic perfusion for the resuscitation and assessment of human kidneys discarded because of inadequate in situ perfusion

Kidney no Perfusion grade EVNP score Remuzzi score ATI
Score 1 and 2
 2 1 1 9 None
 3 4 2 6 Moderate
 5 4 2 4 Mild
 6 2 2 3 Mild
 7 1 1 7 None
 11 1 2 10 None
 12 4 1 6 Milda
 14 1 2 4 Mild to moderate
 15 4 1 5 Mild to moderateb
 17 1 2
 18 1 2 0 Mild
 21 3 2 3 Mild
Score 3 and 4
 4 4 4 2 None
 8 2 3 3 Mild
 9 2 3 1 Mild
 16 4 3 6 None
 19 1 3 2 Mild
 20 4 3 5 Mild
 22 3 3 Moderate
Score 5     
 1 1 5 0 Nonea
 10 3 5 Severe
 13 3 5 6 Nonec
  1. A wedge biopsy was taken on arrival at the laboratory after the period of static cold storage. The tissue was fixed in 10 % formal saline then embedded in paraffin wax. Sections from the paraffin embedded tissue were cut (4 µm) and stained with H&E for histopathological scoring. Sections were assessed using the Remuzzi score by a consultant pathologist who was blinded to the donor types. Four different parameters were assessed in the scoring system; Glomerular global sclerosis, tubular atrophy, interstitial fibrosis and vascular lesions (8). The score ranged from a minimum of 0 (indicating the absence of renal lesions) to 3 (severe). The sum of the four parameters was then calculated. A score of 0–3 indicated mild changes, 4–6 moderate and 7–12 severe. Sections were graded mild, moderate and severe for the presence of acute tubular injury. Pairs of kidneys; (8, 9), (11, 12), (15, 16), (17, 18), (19, 20) and (21, 22)
  2. aVacuolation of the proximal tubular epithelial cells
  3. bGlomerular capillary thrombi
  4. cGlomerular capillary thrombi and early cortical necrosis