Bashir Shaarif, Hussain Mudassar, Ali Khan Azhar, Hassan Usman, Mushtaq Khawaja Sajid, Hameed Maryam, Awan Usman Ayub
Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore 54000, Pakistan.
Department of Nephrology, Shaikh Zayed Hospital, Lahore 54000, Pakistan.
Int J Nephrol. 2020 Dec 7;2020:7289701. doi: 10.1155/2020/7289701. eCollection 2020.
Renal transplant has emerged as a preferred treatment modality in cases of end-stage renal disease; however, a small percentage of cases suffer from graft dysfunction.
To evaluate the renal transplant biopsies and analyze the various causes of graft dysfunction.
163 renal transplant biopsies, reported between 2014 and 2019 and who fulfilled the inclusion criteria, were evaluated with respect to demographics, clinical, histological, and immunohistochemical features.
Of 163 patients, 26 (16%) were females and 137 (84%) were males with a mean age of 34 ± 7 years. 53 (32.5%) cases were of rejection (ABMR and TCMR), 1 (0.6%) was borderline, 15 were of IFTA, and rest of 94 cases (57.7%) belonged to the others category. SCr (serum creatinine) in cases of rejection was 3.85 ± 0.55 mg/dl. Causes of early graft dysfunction included active ABMR (7.1 ± 4.7 months), acute TCMR (5.5 months), and acute tubular necrosis (after 6 ± 2.2 months of transplant) while the causes of late rejection were CNIT and IFTA (34 ± 4.7 and 35 ± 7.8 months, respectively).
Renal graft dysfunction still remains a concerning area for both clinicians and patients. Biopsy remains the gold standard for diagnosing the exact cause of graft dysfunction and in planning further management.
肾移植已成为终末期肾病患者首选的治疗方式；然而，仍有一小部分病例出现移植肾功能障碍。
评估肾移植活检情况并分析移植肾功能障碍的各种原因。
对2014年至2019年间报告的163例符合纳入标准的肾移植活检病例，从人口统计学、临床、组织学和免疫组化特征方面进行评估。
163例患者中，女性26例（16%），男性137例（84%），平均年龄34±7岁。53例（32.5%）为排斥反应（抗体介导的排斥反应和细胞介导的排斥反应），1例（0.6%）为临界状态，15例为慢性移植肾肾病，其余94例（57.7%）属于其他类别。排斥反应病例的血清肌酐为3.85±0.55mg/dl。早期移植肾功能障碍的原因包括活动性抗体介导的排斥反应（7.1±4.7个月）、急性细胞介导的排斥反应（5.5个月）和急性肾小管坏死（移植后6±2.2个月），而晚期排斥反应的原因是慢性移植肾肾病和慢性移植肾肾病（分别为34±4.7个月和35±7.8个月）。
肾移植功能障碍仍然是临床医生和患者都关注的领域。活检仍然是诊断移植肾功能障碍确切原因和规划进一步治疗的金标准。
