Effect of histological damage on long-term kidney transplant outcome
Effect of histological damage on long-term kidney transplant outcome
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DOI：
10.1097/00007890-200102270-00006
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发表时间：
2001-02-27
期刊：
影响因子：
6.2
通讯作者：
Chapman, JR
中科院分区：
文献类型：
--
作者：
Nankivell, BJ;Fenton-Lee, CA;Chapman, JR
背景慢性移植肾衰竭仍然是一个重大的挑战，以克服。已知供体质量、移植物功能延迟恢复（DGF）、急性排斥反应和免疫抑制等因素会影响长期预后，但它们与组织学损伤和移植物预后的关系尚不清楚。在移植后3个月获得的方案肾活检（n=112）产生了102个足够的组织。采用Banff评分法对组织学进行评分，并与植入活检（n=91）、重复12个月组织学检查（n=39）、血清肌酐和连续同位素肾小球滤过率下降、慢性移植物肾病（CAN）发生率以及移植物存活率进行比较。中位随访时间为9.3年，20例患者发生移植物衰竭，26例患者死亡，移植物功能正常。Banff慢性肾病在3个月活检中的发生率为24%，并且可以通过供体微血管病变、冷缺血、DGF和急性血管排斥反应预测（P
Background. Chronic renal allograft failure remains a major challenge to overcome. Factors such as donor quality, delayed graft function (DGF), acute rejection, and immunosuppression are known to affect longterm outcome, but their relationship to histological damage to graft outcome is unclear.Methods. Protocol kidney biopsies (n=112) obtained at 3 months after transplantation yielded 102 with adequate tissue. Histology was scored by the Banff scheme, and compared with implantation biopsies (n=91), repeat 12-month histology (n=39), decline in serum creatinine and serial isotopic glomerular filtration rate, onset of chronic allograft nephropathy (CAN), and actuarial graft survival censored for death with a functioning graft.Results. At a median follow-up of 9.3 years, 20 patients had graft failure and 26 died with a functioning graft. Banff chronic nephropathy was present in 24% of 3-month biopsies, and was predicted by microvascular disease in the donor, cold ischemia, DGF, and acute vascular rejection (P