胰腺移植活检组织病理学变化谱及其与移植物丢失的关系。

Spectrum of histopathological changes in pancreas allograft biopsies and relationship to graft loss.

作者信息

Drachenberg C B, Papadimitriou J C

机构信息

Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA.

出版信息

Transplant Proc. 2007 Sep;39(7):2326-8. doi: 10.1016/j.transproceed.2007.06.017.

DOI:10.1016/j.transproceed.2007.06.017

PMID:17889178

Abstract

Histological evaluation of pancreas allografts through the use of needle biopsies is of paramount importance for the determination of the etiology of graft dysfunction. In addition, pathological assessment of the overall status of the exocrine, endocrine, and vascular components provides invaluable information with regards to the prognosis of the graft. Pancreas allograft failure results from a variety of causes, highly dependent on the time posttransplantation, but after the first 6 months' posttransplantation the most common cause of graft loss is chronic rejection. The main histological manifestations of chronic rejection are progressive graft sclerosis (increasing fibrosis and proportional atrophy of the glandular components), secondarily leading to endocrine failure. Evaluation of serial biopsies in patients with graft failure has shown that the most important histological predictors of chronic rejection/graft sclerosis are diffuse acinar inflammation and acute and chronic vascular injury in the form of intimal arteritis and proliferative transplant arteriopathy, respectively.

摘要

通过针吸活检对胰腺同种异体移植进行组织学评估对于确定移植功能障碍的病因至关重要。此外，对外分泌、内分泌和血管成分的整体状况进行病理评估可为移植的预后提供宝贵信息。胰腺同种异体移植失败由多种原因导致，高度依赖于移植后的时间，但移植后6个月后，移植丢失的最常见原因是慢性排斥反应。慢性排斥反应的主要组织学表现为移植胰腺进行性硬化（纤维化增加和腺性成分成比例萎缩），继而导致内分泌功能衰竭。对移植失败患者的系列活检评估表明，慢性排斥反应/移植胰腺硬化最重要的组织学预测指标分别是弥漫性腺泡炎症以及内膜动脉炎和增殖性移植性动脉病形式的急慢性血管损伤。