供体肾中的间质成纤维细胞可预测移植后晚期贫血。

Interstitial fibroblasts in donor kidneys predict late posttransplant anemia.

作者信息

Mafune Hamada Aki, Yamamoto Izumi, Kawabe Mayuko, Katsumata Haruki, Yamakawa Takafumi, Katsuma Ai, Nakada Yasuyuki, Kobayashi Akimitsu, Koike Yusuke, Miki Jun, Yamada Hiroki, Kimura Takahiro, Tanno Yudo, Ohkido Ichiro, Tsuboi Nobuo, Yamamoto Hiroyasu, Urashima Mitsuyoshi, Yokoo Takashi

机构信息

Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.

Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.

出版信息

Clin Kidney J. 2019 Sep 24;14(1):132-138. doi: 10.1093/ckj/sfz122. eCollection 2021 Jan.

DOI:10.1093/ckj/sfz122

PMID:33564411

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7857797/

Abstract

BACKGROUND

Posttransplant anemia (PTA) is associated with the progression of kidney disease and mortality in kidney transplant recipients. Although the main causes of PTA are recipient factors, donor factors have not been fully investigated. In this study we investigated the association of donor pathological findings with the incidence of PTA in kidney transplant recipients after 3 years of transplantation.

METHODS

We conducted a retrospective cohort study at a single university hospital. A total of 50 consecutive adult recipients and donors were enrolled. To assess the structure of interstitial lesions, immunohistochemical staining of interstitial fibrosis and fibroblasts were assessed in 0-h biopsies for quantitative analysis.

RESULTS

The incidence of PTA in this cohort was 30%. The mean hemoglobin (Hb) was 11.6 ± 0.8 g/dL in patients with PTA and 14.3 ± 1.5 g/dL in patients without PTA. An inverse association was observed in biopsies between interstitial fibrosis area and interstitial fibroblast area (P < 0.01) and each pathological finding was examined for its association with PTA incidence after multivariate adjustment. For the interstitial fibrosis area, the odds ratio (OR) was 1.94 [95% confidence interval (CI) 1.26-2.99; P < 0.01]. For the interstitial fibroblast area, the OR was 0.01 (95% CI 0.00-0.16; P < 0.01). Receiver operating characteristics curve analysis indicated that the interstitial fibroblast area had high predictive power for the incidence of PTA.

CONCLUSIONS

The presence of interstitial fibroblasts in donor kidneys may play an important role in predicting the incidence of PTA.

摘要

背景

移植后贫血（PTA）与肾移植受者的肾脏疾病进展及死亡率相关。尽管PTA的主要原因是受者因素，但供者因素尚未得到充分研究。在本研究中，我们调查了移植3年后供者病理结果与肾移植受者PTA发生率之间的关联。

方法

我们在一家大学医院进行了一项回顾性队列研究。共纳入50例连续的成年受者和供者。为评估间质病变的结构，对0小时活检组织进行间质纤维化和成纤维细胞的免疫组化染色，以进行定量分析。

结果

该队列中PTA的发生率为30%。发生PTA的患者平均血红蛋白（Hb）为11.6±0.8 g/dL，未发生PTA的患者平均血红蛋白为14.3±1.5 g/dL。在活检组织中观察到间质纤维化面积与间质成纤维细胞面积呈负相关（P<0.01），并且在多变量调整后检查了每个病理结果与PTA发生率的关联。对于间质纤维化面积，比值比（OR）为1.94[95%置信区间（CI）1.26 - 2.99；P<0.01]。对于间质成纤维细胞面积，OR为0.01（95%CI 0.00 - 0.16；P<0.01）。受试者工作特征曲线分析表明，间质成纤维细胞面积对PTA发生率具有较高的预测能力。