Clark R L, Mandel S R, Webster W P
Invest Radiol. 1977 Jan-Feb;12(1):62-73. doi: 10.1097/00004424-197701000-00014.
The progressive microvascular changes occurring during unmodified renal allograft rejection were studied in 22 dogs utilizing post-mortem barium sulfate perfusion microangiography. Sixteen dogs (7 autografts, 8 ischemia controls and 1 hydronephrotic animal) made up a control group. The microradiographic findings were correlated with intravenous urography, coagulation profiles and histopathologic studies. Vascular obstruction and obliteration occur from the outer cortex inward and involve sequentially, capillaries, efferent arterioles, glomeruli, afferent arterioles and interlobular arteries. A-V communications develop late and are due to a loss in vascular integrity. Medullary vascular obliteration occurs subsequent to cortical changes. The microangiographic changes mirror the hstologically evident cellular infiltrate, vascular damage and eventual hemorrhagic necrosis. The appearance of fibrin split products in the plasma late in rejection and the dramatic vascular occlusive changes seen microangiographically suggest that localized intravascular coagulation occurs during rejection.
利用尸检硫酸钡灌注微血管造影术，对22只狗在未修饰的同种异体肾移植排斥反应过程中发生的进行性微血管变化进行了研究。16只狗（7只自体移植、8只缺血对照和1只肾积水动物）组成一个对照组。微血管造影结果与静脉肾盂造影、凝血指标和组织病理学研究相关。血管阻塞和闭塞从外皮质向内发生，并依次累及毛细血管、出球小动脉、肾小球、入球小动脉和小叶间动脉。动静脉交通出现较晚，是由于血管完整性丧失所致。髓质血管闭塞发生在皮质变化之后。微血管造影变化反映了组织学上明显的细胞浸润、血管损伤和最终的出血性坏死。排斥反应后期血浆中纤维蛋白裂解产物的出现以及微血管造影所见的显著血管闭塞性变化表明，排斥反应期间发生了局部血管内凝血。
