Howie A J, Brewer D B
J Pathol. 1983 Feb;139(2):193-206.
Sections from 266 renal allografts that had been transplanted and removed were studied to determine the prevalence of deposits of Tamm-Horsfall protein outside tubules and resulting from tubular rupture, detected by the periodic acid-Schiff (PAS) reaction. The PAS-positive material was shown to be Tamm-Horsfall protein by an indirect immunoperoxidase method. Deposits were found in 152 kidneys (57.1 per cent.), and were commonest at the cortico-medullary junction and in arcuate veins. Deposits were rarely associated with thrombosis or an inflammatory response, and often contained tubules that were reforming. The lesions were rare in grafts totally infarcted from occlusion of the main vessels. Deposits were mostly found in kidneys that had tubular damage from acute rejection reactions, often with ureteric damage, but a few had ureteric obstruction alone. Old deposits were identified in kidneys showing chronic vascular rejection. No features of the deposits themselves could separate cases with ureteric obstruction alone from the other cases. Not every case with ureteric obstruction had the lesions. Extra-tubular deposits of Tamm-Horsfall protein are common in renal allografts and only rarely indicate a specific, surgically-correctable cause of graft dysfunction, namely ureteric obstruction.
对266例已移植并切除的同种异体肾移植切片进行研究，以确定通过过碘酸希夫（PAS）反应检测到的肾小管外及由肾小管破裂导致的Tamm-Horsfall蛋白沉积的发生率。通过间接免疫过氧化物酶法显示PAS阳性物质为Tamm-Horsfall蛋白。在152个肾脏中发现了沉积物（57.1%），最常见于皮质-髓质交界处和弓形静脉。沉积物很少与血栓形成或炎症反应相关，且常包含正在重塑的肾小管。在因主血管闭塞而完全梗死的移植物中，病变罕见。沉积物大多见于因急性排斥反应而有肾小管损伤的肾脏，常伴有输尿管损伤，但少数仅存在输尿管梗阻。在显示慢性血管排斥反应的肾脏中发现了陈旧性沉积物。沉积物本身的特征无法将仅患有输尿管梗阻的病例与其他病例区分开来。并非每个输尿管梗阻病例都有这些病变。肾小管外Tamm-Horsfall蛋白沉积物在同种异体肾移植中很常见，仅很少表明移植功能障碍的一种特定的、可通过手术纠正的原因，即输尿管梗阻。
