Bosmans Jean-Louis, Ysebaert Dirk K, Verpooten Gert A
Department of Nephrology-Hypertension, Antwerp University Hospital, Belgium.
Transplantation. 2008 Apr 15;85(7 Suppl):S38-41. doi: 10.1097/TP.0b013e318169c5d0.
Chronic allograft nephropathy, characterized by interstitial fibrosis and tubular atrophy, is still a major cause of graft loss after kidney transplantation. The complex pathophysiology of chronic allograft nephropathy is still poorly understood, and could be clarified by a more systematic performance of implantation and protocol biopsies of the renal allograft. This review highlights the contribution of implantation and protocol biopsies to our current knowledge of the complex interaction of multiple processes, ultimately leading to the development of interstitial fibrosis and tubular atrophy in the transplanted kidney. In addition, the safety and the limitations of protocol biopsies are discussed, as well as potential future directions for clinical practice and clinical research.
慢性移植肾肾病以间质纤维化和肾小管萎缩为特征，仍是肾移植后移植肾丢失的主要原因。慢性移植肾肾病复杂的病理生理学仍未得到充分理解，通过对肾移植进行更系统的植入活检和方案活检可能会得以阐明。本文综述重点介绍了植入活检和方案活检对我们目前了解多个过程复杂相互作用所做的贡献，这些相互作用最终导致移植肾间质纤维化和肾小管萎缩的发生。此外，还讨论了方案活检的安全性和局限性，以及临床实践和临床研究未来可能的发展方向。
