Okamoto Masahiko, Akioka Kiyokazu, Ushigome Hidetaka, Higuchi Atsushi, Nobori Shuji, Ogino Shiro, Uryuhara Kenji, Kaihara Satoshi, Hatta Tsuguru, Urasaki Koji, Yoshimura Norio
Department of Organ Interaction Research Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Clin Transplant. 2006;20 Suppl 15:16-9. doi: 10.1111/j.1399-0012.2006.00544.x.
Ten-year protocol biopsies were performed in 16 patients treated with calcineurin inhibitor (CNI) continuously. All kidney grafts were functioning well at the time of biopsy with the mean serum creatinine level of 1.6 +/- 0.8 mg/dL. The specimen of biopsy showed various degrees of tissue injury. According to the Banff grading, allograft glomerulopathy (cg) was observed in one case. Interstitial fibrosis (ci) and tubular atrophy (ct) were observed more frequently in 13 (81%) and 15 (93%) cases, respectively. Fibrous intimal thickening (cv) was seen in one (7%) case. Arteriolar hyaline thickening (ah) was seen in 14 (87%) cases. These findings were associated with chronic rejection in one case, recurrence of original disease in four (25%) cases, toxicity of CNI in 14 (87%) cases. Longer follow-up studies are needed to confirm whether CNI should be continued or not in the long-term period following kidney transplantation for better graft survival.
对16例持续接受钙调神经磷酸酶抑制剂（CNI）治疗的患者进行了为期10年的方案活检。在活检时，所有肾移植均功能良好，平均血清肌酐水平为1.6±0.8mg/dL。活检标本显示出不同程度的组织损伤。根据Banff分级，1例观察到移植肾肾小球病（cg）。13例（81%）和15例（93%）分别更频繁地观察到间质纤维化（ci）和肾小管萎缩（ct）。1例（7%）出现纤维内膜增厚（cv）。14例（87%）出现小动脉玻璃样增厚（ah）。这些发现与1例慢性排斥反应、4例（25%）原发病复发、14例（87%）CNI毒性有关。需要进行更长时间的随访研究，以确定肾移植后长期是否应继续使用CNI，以提高移植肾的存活率。
