Hailemariam S
Departement Pathologie, Universitätsspital Zürich.
Schweiz Med Wochenschr. 2000 Jun 24;130(25):952-6.
Kidney biopsy is an important diagnostic tool for the evaluation of kidney transplantation. Histological evaluation of the donor kidney serves to identify risk factors for recurrent disease, neoplasia and/or graft failure due to numerous factors such as damage to the donor kidney during surgical removal or implantation, injury sustained during the transport process between the donor and recipient, and less than optimal allograft perfusion during the intra- and postoperative period. The most important question for the pathologist is the cause of renal dysfunction (rejection) after transplantation. The value of renal allograft biopsy has been significantly enhanced by several developments: improved, internationally accepted classification of kidney transplantation pathology (Banff 1997) and the development of molecular biological techniques such as RT-PCR evaluation of perforin, granzyme B and Fas ligand, which can be applied to renal allograft tissue to obtain a diagnosis of acute rejection with high sensitivity and specificity, are very promising but not used in routine diagnosis.
肾活检是评估肾移植的重要诊断工具。对供体肾进行组织学评估有助于识别因多种因素导致的复发性疾病、肿瘤形成和/或移植失败的风险因素，这些因素包括手术切除或植入过程中对供体肾的损伤、供体与受体之间运输过程中受到的损伤，以及术中和术后同种异体移植灌注不理想等情况。病理学家面临的最重要问题是移植后肾功能障碍（排斥反应）的原因。肾移植活检的价值因以下几个进展而显著提高：改进的、国际认可的肾移植病理学分类（1997年班夫分类法），以及分子生物学技术的发展，如对穿孔素、颗粒酶B和Fas配体进行逆转录聚合酶链反应（RT-PCR）评估，这些技术可应用于肾移植组织，以高灵敏度和特异性诊断急性排斥反应，非常有前景，但尚未用于常规诊断。
