Hansen Ditte, Rørvig Sara, Andersen Claus B, Sørensen Søren S
Department of Nephrology, Herlev Hospital, Copenhagen, Denmark.
Department of Nephrology, Rigshospitalet, Copenhagen, Denmark.
APMIS. 2018 Jan;126(1):3-8. doi: 10.1111/apm.12781. Epub 2017 Nov 20.
Fibrin thrombi (FT) are occasionally found in the pre-implantation biopsy of kidneys from deceased donors. The aim of this study was to monitor the prevalence and answer the question whether FT has any impact on future graft function in a Danish patient cohort. We looked for FT in all donor kidney biopsies taken at the time of renal transplantation in a Danish transplantation unit during a 10-year period. Every recipient transplanted with a FT donor kidney (n = 15) were matched with up to five control recipients (n = 69), and graft function and graft survival were assessed. FT was present in 3% of the transplanted donor kidneys. Graft function was reduced in the FT group 6 months after transplantation (median estimated glomerular filtration rate (eGFR): 29 mL/min vs 46 mL/min; p = 0.017), but at 12 months, an apparent difference did not reach statistical significance. More patients were on dialysis in the FT group after 12 months compared with the control group (27% vs 6%; p = 0.049). In conclusion, FT in donor kidney biopsies at time of transplantation is a risk factor for the development of reduced renal function during the first year of transplantation.
纤维蛋白血栓（FT）偶尔会在已故供体肾脏的植入前活检中被发现。本研究的目的是监测其发生率，并回答FT是否对丹麦患者队列中未来的移植肾功能有任何影响这一问题。我们在丹麦一个移植单位10年期间肾移植时获取的所有供体肾脏活检样本中寻找FT。每例接受FT供体肾脏移植的受者（n = 15）与多达5例对照受者（n = 69）进行匹配，并评估移植肾功能和移植肾存活情况。3%的移植供体肾脏存在FT。移植后6个月，FT组的移植肾功能降低（估计肾小球滤过率（eGFR）中位数：29 mL/分钟对46 mL/分钟；p = 0.017），但在12个月时，明显差异未达到统计学意义。与对照组相比，12个月后FT组有更多患者接受透析（27%对6%；p = 0.049）。总之，移植时供体肾脏活检中存在FT是移植后第一年肾功能下降的一个危险因素。
