Department of Nephrology and Renal Transplantation, Institute of Kidney Diseases, Peshawar, Pakistan.
J Coll Physicians Surg Pak. 2021 Feb;31(2):197-201. doi: 10.29271/jcpsp.2021.02.197.
To determine the pattern of histopathology in living-related, kidney transplant recipients (KTRs) from a transplant centre in Khyber Pakhtunkhwa (KPK), Pakistan.
Descriptive, observational study.
Institute of Kidney Diseases, Peshawar, from August 2008 to July 2018.
A retrospective review of graft biopsy reports and clinical charts from living-related, kidney transplant recipients was carried out. Allograft biopsies were done for graft dysfunction with no apparent cause. The biopsy pathology was classified according to updated Banff classifications. The descriptive statistics were used to tabulate the results.
Out of the 55 biopsies, 51 (92.73%) were from males with mean age of 34.35±9.40 years. Out of 52 percutaneous biopsies, 10 (19.23%) belonged to the normal category. Category 2 (borderline rejection) and 3 (acute/active cellular rejection) were seen in three (5.7%) and one (1.9%) cases, respectively. Interstitial fibrosis/tubular atrophy (Banff Category 5) was observed in 18 (34.62%) cases. Banff Category 6 (others) was seen in 19 (36.5%) cases, in which calcineurin inhibitors (CNI) toxicity was commonest (17 [89.4%] of 19 cases). Mixed lesions were found in 19 (36.5%) cases. Out of the 19 mixed category cases, 12 (63.16%) showed both Category 3 and Category 5 changes with most of the cases showing mild to moderate IF/TA; while one case had severe IF/TA. Three graft nephrectomies were done, one each for recurrent oxalosis, nephroblastoma and fungal infection.
Among the studied specimens, mixed lesions were the predominant findings, followed by others (mostly CNI toxicity) and IFTA categories. The frequency of acute/active rejections was low and that of chronic changes higher, in keeping with delayed biopsies. Key Words: Allograft biopsy, Graft dysfunction, Rejection, Kidney.
确定巴基斯坦开伯尔-普赫图赫瓦省（KPK）一家移植中心活体相关肾移植受者（KTR）的组织病理学模式。
描述性、观察性研究。
白沙瓦肾脏病研究所，2008 年 8 月至 2018 年 7 月。
对活体相关肾移植受者的移植物活检报告和临床图表进行回顾性审查。对无明显原因的移植物功能障碍进行同种异体移植活检。根据最新的 Banff 分类对移植病理进行分类。使用描述性统计对结果进行制表。
55 例活检中，51 例（92.73%）来自男性，平均年龄 34.35±9.40 岁。52 例经皮活检中，10 例（19.23%）属于正常类别。3 例（5.7%）和 1 例（1.9%）分别属于 2 类（边缘排斥）和 3 类（急性/活跃细胞排斥）。18 例（34.62%）观察到间质纤维化/肾小管萎缩（Banff 第 5 类）。Banff 第 6 类（其他）见于 19 例（36.5%），其中钙调神经磷酸酶抑制剂（CNI）毒性最常见（19 例中有 17 例[89.4%]）。19 例混合病变中有 19 例（36.5%）同时存在 3 类和 5 类病变，大多数病例表现为轻度至中度 IF/TA；而 1 例为严重 IF/TA。3 例进行了移植肾切除术，分别用于复发性草酸钙沉积症、肾母细胞瘤和真菌感染。
在所研究的标本中，混合病变是主要发现，其次是其他病变（主要是 CNI 毒性）和 IFTA 类别。急性/活跃排斥的频率较低，慢性改变的频率较高，与延迟活检相符。关键词：同种异体移植物活检、移植物功能障碍、排斥、肾脏。
