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移植肾穿刺病理组织中抗体介导的排斥反应 被引量:1

Antibody mediated rejection during transplant kidney biopsy
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摘要 背景:体液性排斥以激素耐受和难治性为其显著的特点,常常发生在免疫高敏的受者身上。目的:对肾功能不全移植肾进行常规穿刺病理活检,根据病理诊断观察抗体介导性排斥反应的治疗效果,分析移植肾穿刺病理活检的安全性。方法:选取肾移植后有移植肾穿刺活检指征的患者84例,在B超引导下应用BARD(美国)活检穿刺针行移植肾穿刺活检,活检组织行常规苏木精-伊红染色,组织化学染色,同时常规行C4d免疫组织化学染色,依据Banff’05标准进行病理分型,根据病理状态明确诊断进行相应的临床治疗,观察治疗效果。结果与结论:84例患者除1例由于组织少难以诊断,其余病理诊断移植肾超急性排斥反应1例,急性抗体介导性排斥反应5例,慢性抗体介导性排斥反应2例,C4d免疫组织化学染色阳性16例。经过治疗8例抗体介导性排斥反应患者中4例移植肾功能得以恢复,3例未恢复,1例移植肾失功,移植肾切除。患者无不良反应发生。结果表明移植肾穿刺病理活检对移植肾无不良影响。 BACKGROUND:Acute humoral rejection, characterized as hormone resistance and refractory feature, often occurs in immune hypersensitivity recipients. OBJECTIVE:To observe the effect on antibody-mediated rejection during transplant kidney biopsy and to analyze the safety of transplant kidney biopsy. METHODS:Eighty-four patients underwent transplant kidney biopsy following renal transplantation. The biopsy was performed using B-ultrasound guided BARD puncture. Hematoxylin-eosin staining, histochemical staining and C4d immunohistochemical staining were performed. All biopsies were systematically diagnosed and evaluated according to the Banf 2005 schema. RESULTS AND CONCLUSION:Except for 1 case which was difficult to diagnose because of few tissues, there were 1 case of hyperacute rejection, 5 of acute antibody mediated rejection, 2 of chronic antibody mediated rejection, and 16 positive for C4d. After treatment, 4 of 8 antibody mediated rejection cases recovered renal transplantation, 3 did not recover, and 1 lost renal function. There were no adverse effects. The results showed that transplant kidney biopsy is safe and reliable for the assist diagnosis and treatment of renal dysfunction after renal transplantation.
出处 《中国组织工程研究与临床康复》 CAS CSCD 北大核心 2011年第18期3311-3314,共4页 Journal of Clinical Rehabilitative Tissue Engineering Research
基金 十一五国家科技支撑计划基金项目(2008BAI60B04) 课题名称:抗排斥反应关键诊疗技术的开发研究~~
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参考文献33

  • 1Valente M,Furian L,Marchini F,et al.C4d-positive renal allograft rejection biopsies in cyclosporine-treated patients:single-center incidence and outcome.Transplant Proc.2010;42(6):2214-2217.
  • 2Atsumi H,Asaka M,Kimura S,et al.A case of second renal transplantation with acute antibody-mediated rejection complicated with BK virus nephropathy.Clin Transplant.2010;24Suppl 22:35-38.
  • 3Jirasiritham S,Khunprakant R,Techawathanawanna N,et al.Treatment of simultaneous acute antibody-mediated rejection and acute cellular rejection with alemtuzumab in kidney transplantation:a case report.Transplant Proc.2010;42(3):987-989.
  • 4Randhawa PS,Schonder K,Shapiro R,et al.Polyomavirus BK neutralizing activity in human immunoglobulin preparations.Transplantation.2010;89 (12):1462-1465.
  • 5Solez K,Colvin RB,Racusen LC,et al.Banff '05 Meeting Report:Differential Diagnosis of Chronic Allograft Injury and Elimination of Chronic Allograft Nephropathy.American Journal of Transplantation.2007; 7:518-526.
  • 6Nickeleit V,Zeiler M,Gudat F,et al.Detection of the complement degradation product C4d in renal allografts:diagnostic and therapeutic implications.J Am Soc Nephrol.2002:13:242.=3.
  • 7Racusen LC,Colvin RB,Solez K et al.Antibody-mediated rejection criteria-an addition to the Banff 97 classification of renal allograft rejection.Am J Transplant.2003; 3:708-714.
  • 8郭晖,王莺,林正斌,李锦文,明长生,沙波,刘斌,魏来,蒋继贫.移植肾活组织检查191例的病理学研究[J].中华器官移植杂志,2001,22(2):82-84. 被引量:13
  • 9Okur A,Kantarci M,Akgun M,et al.Unbiased estimation of tumor regression rates during chemoradiotherapy for esophageal carcinoma using CT and stereology.Dis Esophagus.2005;18(2):114-119.
  • 10Sekijima M,Shimizu A,Ishii Y,et al.Early humoral-mediated graft injuries in ABO-incompatible kidney transplantation in human beings.Transplant Proc.2010;42(3):789-90.

二级参考文献20

  • 1邹万忠,王海燕.进一步提高肾活检病理诊断的质量[J].诊断学理论与实践,2002,1(1):8-9. 被引量:8
  • 2董鸿瑞,程虹,谌贻璞,邹万忠.甲醛固定石蜡包埋肾组织做免疫荧光染色在病理诊断中的应用[J].中华肾脏病杂志,2005,21(6):315-319. 被引量:15
  • 3黄受方,中华病理学杂志,1988年,17卷,19页
  • 4李维华,中华病理学杂志,1982年,11卷,19页
  • 5Pirani CL. Renal biopsy: a historical perspective. In: Silva FG, D'Agati VD, Nadasdy T. eds. Renal biopsy interpretation.New York: Churchill Livingstone, 1997. 1-19.
  • 6赵魁丹 周惠英.肾脏穿刺活体组织检查初步报告[J].中华内科杂志,1958,6:694-697.
  • 7汤伯琴 刘平 唐子进.肾穿刺活体组织检查的初步报告[J].北京医学院学报,1964,3:49-51.
  • 8谢竹藩 刘平 汤伯琴.肾穿刺活体组织检查[J].北京医学院学报,1964,3:103-106.
  • 9Madaio MP.Renal biopsy.Kidney Int,1990,38:529-543.
  • 10Furness PN, Boyd S. Electron microscopy and immunocytochemistry in the assessment of renal biopsy specimens: actual and optimal practice. J Clin Pathol, 1996, 49: 233-237.

共引文献338

同被引文献16

  • 1邹万忠.发展和提高我国的肾活检病理检查水平[J].中华肾脏病杂志,2005,21(6):303-305. 被引量:14
  • 2Randhawa PS,Schonder K,Shapiro R. Polyomavirus BK neutralizing activity in human immunoglobulin preparations[J].{H}TRANSPLANTATION,2010,(12):1462-1465.
  • 3Obeidat MA,Luyckx VA,Grebe SO. Post-transplant nuclear renal scans correlate with renal injury biomarkers and early al ograft outcomes[J].{H}Nephrology Dialysis Transplantation,2011,(09):3038-3045.
  • 4Renoult E,Coutlée F,Paquet M. Evaluation of a preemptive strategy for BK polyomavirus-associated nephropathy based on prospective monitoring of BK viremia:a kidney transplantation center experience[J].{H}TRANSPLANTATION PROCEEDINGS,2010,(10):4083-4087.
  • 5Günther OP,Lin D,Balshaw RF. Effects of sample timing and treatment on gene expression in early acute renal al ograft rejection[J].{H}TRANSPLANTATION,2011,(03):323-329.
  • 6Han Y,Shi BY,Cai M. CD20 expression in the transplanted kidney of patients with graft loss and transient al ograft dysfunction[J].J Med Biochem,2012,(01):1-5.
  • 7陈实.移植病理学[M]{H}武汉:湖北科学技术出版社,1998209-216.
  • 8John R,Konvalinka A,Tobar A. Determinants of long-term graft outcome in transplant glomerulopathy[J].{H}TRANSPLANTATION,2010,(07):757-764.
  • 9Mihovilovi?K,Kardum-Skelin I,Ljubanovi?D. Urine immunocytology as a noninvasive diagnostic tool for acute kidney rejection:a single center experience[J].Col Antropol,2010,(01):63-67.
  • 10Ranjan P,Nada R,Jha V. The role of C4d immunostaining in the evaluation of the causes of renal al ograft dysfunction[J].{H}Nephrology Dialysis Transplantation,2008,(05):1735-1741.

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