Evaluation of Renal Allograft Fibrosis by Transient Elastography (Fibro Scan)
Evaluation of Renal Allograft Fibrosis by Transient Elastography (Fibro Scan)
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DOI：
10.1016/j.transproceed.2014.12.034
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发表时间：
2015-04-01
影响因子：
0.9
通讯作者：
Yoshimura, N.
中科院分区：
文献类型：
--
作者：
Nakao, T.;Ushigome, H.;Yoshimura, N.
背景。慢性同种异体移植物损伤（CAI）是导致肾移植术后移植失败的最重要因素之一。方案活检是揭示亚临床同种异体肾移植失败的最有价值的工具。瞬时弹性成像（TE）是一种无创技术，已显示出可用于评估肝和肾纤维化。本研究旨在评估 TE 是否是评估同种异体移植肾衰竭的可行且有效的方法。患者和方法。 35 名患者通过纤维扫描（Echosense，巴黎，法国）接受了 TE。对 27 名患者进行了活检，根据班夫间质慢性变化进行分类：0 级、1 级或 2 级。结果。 35 名患者中有 31 名 (91%) 的实质硬度测量成功。硬度与间质纤维化显着相关 (P < .05)，与估计肾小球滤过率 (eGFR；P < .05) 呈负相关。 eGFR > 50 mL/min 患者的硬度值低于 eGFR < 50 mL/min 的患者 (P < .05)。分类为 CAI Banff 0 级的患者的实质硬度显着低于班夫 1 级或 2 级 CAI 的患者 (P < .05)。 TE测量的肾实质硬度反映了同种异体肾移植物的间质纤维化。结论。对肾实质同种异体移植物硬度的评估可有效识别 CAI 患者，这些患者随后可能受益于活检和免疫抑制方案的修改。肾实质同种异体移植物硬度的评估可有效识别 CAI 患者。 TE 有可能减少准确评估 CAI 所需的肾同种异体移植活检的数量。
Background. Chronic allograft injury (CAI) is one of the most important factors for graft failure after renal transplantation. Protocol biopsy is the most valuable tool for revealing subclinical renal allograft failure. Transient elastography (TE) is a noninvasive technique that has shown utility for the assessment of hepatic and renal fibrosis. This study sought to evaluate whether TE was a viable and effective method for the assessment of renal allograft failure.Patients and Methods. Thirty-five patients underwent TE by Fibro Scan (Echosense, Paris, France). Biopsies were performed in 27 patients, allowing classification according to Banff chronic changes in the interstitium grade 0, grade 1 or grade 2.Results. Measurement of parenchymal stiffness was successful in 31 of 35 patients (91%). Stiffness was significantly correlated with interstitial fibrosis (P < .05) and inversely related with estimated glomerular filtration rate (eGFR; P < .05). Stiffness values of patients with eGFR > 50 mL/min were lower than those of patients with eGFR < 50 mL/min (P < .05). Patients classed as CAI Banff grade 0 had significantly less parenchymal stiffness than patients with Banff grade 1 or grade 2 CAI (P < .05). Parenchymal stiffness measured by TE reflected interstitial fibrosis in renal allograft.Conclusion. Assessment of parenchymal renal allograft stiffness by was effective for identifying patients with CAI who may subsequently benefit from biopsy and modification of the immunosuppressive regimen. Assessment of parenchymal renal allograft stiffness can be effective for identifying patients with CAI. TE has the potential to reduce the number of renal allograft biopsies required for accurate assessment of CAI.