伊朗关于同种异体肾移植疾病的经验。

An Iranian experience on renal allograft diseases.

作者信息

Taheri Diana, Talebi Ardeshir, Salem Venus, Fesharakizadeh Mehdi, Dolatkhah Shahaboddin, Mahzouni Parvin

机构信息

Associate Professor, Isfahan Kidney Diseases Research Center, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Res Med Sci. 2011 Dec;16(12):1572-7.

PMID:22973365

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3434898/

Abstract

BACKGROUND

Renal transplantation is the treatment of choice for most patients with end stage renal disease. In addition, renal biopsy is the gold standard to assess the causes of renal allograft dysfunction. This study was designed to evaluate and designate renal lesions according to Banff schema.

METHODS

In this cross-sectional study, all renal allograft biopsies obtained from renal transplant patients at Alzahra and Noor referral hospitals in Isfahan during 2006-2008 were studied. Evaluations were made according to the Banff classification 2009. Clinical data was collected from the pathology database and analyzed using SPSS.

RESULTS

A total number of 161 specimens were studied from 68% male and 32% female subjects. The donor source was living unrelated in 85%, living related 9.9% and cadaveric in 5% of cases. Pathologic results showed 22.4% acute tubular necrosis (ATN), 13.7% interstitial fibrosis and tubular atrophy (IF/TA) grade II, 9.9% IF/TA (Grade III), 6.8% acute T-cell mediated rejection (TCMR-IA), 5.6% TCMR-IB, 5% borderline change, 5% infarction, 4.3% TCMR-IIA, 4.3% TA/IF (Grade I), 3.7% acute antibody-mediated rejection (ABMR), 1.9% TCMR-IIB and 17.4% other lesions.

CONCLUSIONS

The commonest causes of graft dysfunction after kidney transplant were IF/TA, no evidence of any specific etiology (NOS) and ATN. Living donors were found to be important sources for kidney transplantation in Iran.

摘要

背景

肾移植是大多数终末期肾病患者的首选治疗方法。此外，肾活检是评估肾移植功能障碍原因的金标准。本研究旨在根据班夫标准评估并确定肾损伤情况。

方法

在这项横断面研究中，对2006年至2008年期间从伊斯法罕的阿尔扎赫拉和努尔转诊医院的肾移植患者获取的所有肾移植活检样本进行研究。根据2009年班夫分类法进行评估。从病理数据库收集临床数据，并使用SPSS进行分析。

结果

共研究了161份样本，其中男性受试者占68%，女性受试者占32%。供体来源为85%的非亲属活体供体、9.9%的亲属活体供体和5%的尸体供体。病理结果显示，急性肾小管坏死（ATN）占22.4%，间质纤维化和肾小管萎缩（IF/TA）II级占13.7%，IF/TA（III级）占9.9%，急性T细胞介导的排斥反应（TCMR-IA）占6.8%，TCMR-IB占5.6%，临界变化占5%，梗死占5%，TCMR-IIA占4.3%，TA/IF（I级）占4.3%，急性抗体介导的排斥反应（ABMR）占3.7%，TCMR-IIB占1.9%，其他损伤占17.4%。