Shiramizu T, Hata J, Nakamura K, Hida M, Shinboh T, Nakayama M, Saitoh H, Satoh T
Tokai J Exp Clin Med. 1981 Oct;6(4):357-61.
Eleven out of 31 cases of living renal allografts lost their graft functions. Causes of graft loss were acute rejection in eight cases chronic rejection in one, graft rupture in one, and death due to meningitis with good graft function in one case. Five renal allografts and two biopsy specimens obtained after acute irreversible rejection and one renal allograft due to acute tubular necrosis an rupture were reviewed. We evaluated the correlation between these findings and the irreversibility of renal graft functions. All removed allografts and biopsies demonstrated interstitial edema and cell infiltration. Vascular pathology due to acute irreversible rejection revealed a high level of severity with fibrinoid necrosis and luminal obliteration. These findings suggested that graftectomy and cessation of immunosuppressants were indicated.
31例活体肾移植中有11例移植肾功能丧失。移植肾丧失的原因包括：8例急性排斥反应，1例慢性排斥反应，1例移植肾破裂，1例因脑膜炎死亡但移植肾功能良好。对5例急性不可逆排斥反应后切除的移植肾、2份活检标本以及1例因急性肾小管坏死和破裂切除的移植肾进行了回顾性研究。我们评估了这些发现与移植肾功能不可逆性之间的相关性。所有切除的移植肾和活检标本均显示间质水肿和细胞浸润。急性不可逆排斥反应导致的血管病变表现为严重程度较高，有纤维蛋白样坏死和管腔闭塞。这些发现提示应进行移植肾切除术并停用免疫抑制剂。
