移植肾活检组织临床和病理及免疫病理研究

THE IMMUNOPATHOLOGY OF RENAL GRAFT BIOPSY AND ITS CLINICAL SIGNIFICANCE

目的观察移植肾活检组织病理及免疫病理形态学改变。方法免疫组织化学及组织化学染色。结果急、慢性排斥反应的肾组织均示免疫病理学改变，部分病例示非典型性排斥反应。免疫病理及组织化学染色观察均在移植肾肾小管上皮细胞胞浆内见免疫复合物。结论肾小管上皮细胞内免疫复合物的沉积可能是导致肾小管上皮细胞受损，形成少尿的原因之一。临床上排斥反应症状不典型，免疫抑制等抗排斥反应治疗疗效不佳的病人可能与非典型性排斥反应有关。

objective To investigate the immunologic and histopathologic changes in renal graft biopsy. Methods Immunohistochemical and histochemical stains. Results Immunopathological changes were seen in the renal tissue from the patients who showed acute or chronic rejection changes, or, in some cases, atypical rejection changes. Immunocomplex was seen in the cytoplasm of tubular epithelial cells in all transplanted kidneys. Conclusions The deposition of immunocomplex in the tubular epithelium may cause damages there and play a role in the development of oliguria. The atypical allograft rejection might be relevant to the atypical clinical manifestations and the poor response to the immunosuppresive antirejection treatments.