Peritransplant kidney biopsies: comparison of pathologic interpretations and practice patterns of organ procurement organizations
Peritransplant kidney biopsies: comparison of pathologic interpretations and practice patterns of organ procurement organizations
复制标题
DOI：
10.1111/j.1399-0012.2011.01584.x
复制
发表时间：
2012-05-01
影响因子：
2.1
通讯作者：
Frank, Adam M.
中科院分区：
文献类型：
--
作者：
Singh, Pooja;Farber, John L.;Frank, Adam M.
Singh P，Farber JL，Doria C，Francos GC，Gulati R，Ramirez CB，Maley WR，Frank AM.移植肾周围活检：病理解释与器官获取组织实践模式的比较。?临床移植2012 DOI：10.1111/j.1399-0012.2011.01584.x。(C)John Wiley & Sons A/S.摘要：植入前肾活检通过诊断肾小球硬化、间质纤维化（IF）、动脉硬化和小动脉透明变性影响利用率。器官获取组织（OPO）确定捐赠者是否需要进行活检，捐赠者医院病理学家（DHP）在OPO特定的病理解释表上报告。从40名死者供体肾脏移植在我们的机构活检切片被用来比较我们的移植病理学家和DHP之间的解释。其中33个肾脏还进行了灌注后活检（PPB）。询问了所有58例OPO用于要求植入前活检的标准，并对其病理学解释表进行了分析。移植和DHP在肾小球硬化百分比方面有实质性的一致性，75%的活检在5个百分点内被解释。IF的一致性较差。DHP很少报告动脉病理学。70%的植入前和PPB在肾小球硬化方面的读数相似;其他病变的一致性较弱。在我们的OPO病理解释表上没有动脉疾病的线索。21例OPO的植入前活检标准缺乏统一性，且采用了自行制定的政策。OPO的病理解释形式差异很大。目前关于植入前活检的OPO实践应加以改进。
Singh P, Farber JL, Doria C, Francos GC, Gulati R, Ramirez CB, Maley WR, Frank AM. Peritransplant kidney biopsies: comparison of pathologic interpretations and practice patterns of organ procurement organizations. ?Clin Transplant 2012 DOI: 10.1111/j.1399-0012.2011.01584.x. (C) 2012 John Wiley & Sons A/S. Abstract: The preimplantation kidney biopsy affects utilization by diagnosing glomerulosclerosis, interstitial fibrosis (IF), arteriosclerosis, and arteriolar hyalinosis. Organ procurement organizations (OPOs) determine whether a donor warrants this biopsy and the donor hospital pathologists (DHPs) report on an OPO-specific pathology interpretation form. Biopsy slides from 40 deceased donor kidneys transplanted at our institution were used to compare interpretations between our transplant pathologist and the DHPs. Thirty-three of these kidneys also had post-perfusion biopsies (PPB). All 58 OPOs were queried for criteria used to request a preimplantation biopsy, and their pathology interpretation forms were also analyzed. The transplant and DHPs had substantial agreement for percent glomerulosclerosis with 75% of biopsies being interpreted within five percentage points. Concordance for IF was poor. The DHP rarely reported arterial pathology. Seventy percent of preimplantation and PPB were read similarly for glomerulosclerosis; concordance for other lesions was weaker. There were no cues for arterial disease on our OPOs pathology interpretation form. Criteria for obtaining a preimplantation biopsy lacked uniformity for the 21 OPOs with a self-generated policy. The pathology interpretation forms varied widely among the OPOs. Current OPO practices with regard to the preimplantation biopsy should be improved.