Limas C, Spector D, Wright J R
Am J Pathol. 1977 Aug;88(2):403-28.
The histologic changes in human cadaveric kidneys preserved by either simple hypothermia or continuous pulsatile perfusion were studied by light and electron microscopy and by immunofluorescence in biopsies obtained immediately before (15 kidneys) and approximately 1 hour after (41 kidneys) transplantation. The changes observed in pretransplantation biopsies were largely similar in kidneys preserved by either method with the exception that foreign material was found in the vasculature of perfused kidneys only. Endothelial edema was more frequent and more severe in nonperfused kidneys only. Endothelial edema was more frequent and more severe in nonperfused kidneys. In the 1 hour posttransplantation biopsies, a lesion resembling intravascular coagulation (IVC) was noted in 18 of the 25 perfused kidneys but was absent from all 16 nonperfused kidneys. Transplants with severe IVC lesions failed to function and had extensive cortical necrosis when removed by the end of the first month. In follow-up biopsies, milder lesions appeared to heal fast and were compatible with transplant function. The IVC lesion is probably due to endothelial cell damage during perfusion of the kidneys.
通过光学显微镜、电子显微镜以及免疫荧光技术，对采用单纯低温保存或持续搏动灌注保存的人尸体肾脏的组织学变化进行了研究。这些研究取材于移植前即刻（15个肾脏）以及移植后约1小时（41个肾脏）获取的活检组织。除了仅在灌注肾脏的血管系统中发现异物外，两种保存方法的移植前活检组织中观察到的变化基本相似。仅在未灌注的肾脏中，内皮水肿更为频繁且更为严重。在移植后1小时的活检组织中，25个灌注肾脏中有18个出现了类似血管内凝血（IVC）的病变，而16个未灌注肾脏中均未出现。伴有严重IVC病变的移植肾在第一个月末被切除时无法发挥功能，且出现广泛的皮质坏死。在随访活检中，较轻的病变似乎愈合迅速，且与移植肾功能相符。IVC病变可能是由于肾脏灌注过程中内皮细胞受损所致。
