床边肾脏组织获取对标本充足性的影响和最佳实践。
The Impact of Renal Tissue Procurement at Bedside on Specimen Adequacy and Best Practices.
机构信息
Department of Pathology, University of Texas Medical Branch, Galveston.
Process Improvement Department, University of Texas Medical Branch, Galveston.
出版信息
Am J Clin Pathol. 2019 Jan 7;151(2):205-208. doi: 10.1093/ajcp/aqy120.
OBJECTIVES
Renal biopsy is the gold standard for the diagnosis of both native and allograft renal diseases. We studied the impact of tissue procurement at bedside (TPB) omission on the adequacy of renal biopsies.
METHODS
We compared 120 renal biopsies collected during 2015 using TPB with 111 renal biopsies collected during 2016 when TPB was discontinued. Adequacy criteria were applied as follows: by light microscopy, 10 glomeruli and two arteries for allograft biopsies and seven glomeruli for native biopsies. At least one glomerulus was considered adequate for immunofluorescence and electron microscopy in both groups.
RESULTS
The rate of inadequacies in allograft biopsies increased significantly, from 12.50% to 21.61% (P < .05), when TPB was discontinued.
CONCLUSIONS
Elimination of TPB service had a negative impact on allograft specimen adequacy. Repeat biopsies add cost and delay patient care. Institutions should take this into consideration when considering omission of TPB.
目的
肾活检是诊断原发性和移植肾疾病的金标准。我们研究了在床边（TPB）省略组织采集对肾活检充分性的影响。
方法
我们比较了 2015 年使用 TPB 采集的 120 例肾活检和 2016 年停止 TPB 时采集的 111 例肾活检。充分性标准如下：光镜下，移植肾活检需 10 个肾小球和 2 条动脉，而原发性肾活检需 7 个肾小球。两组免疫荧光和电子显微镜检查均至少有一个肾小球被认为是充分的。
结果
当 TPB 被停止时，移植肾活检的不充分率显著增加，从 12.50%增加到 21.61%（P<.05）。
结论
TPB 服务的消除对移植肾标本的充分性有负面影响。重复活检会增加成本并延迟患者治疗。当考虑省略 TPB 时，机构应考虑到这一点。
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