Human renal isografts: a clinical and pathologic analysis.
Human renal isografts: a clinical and pathologic analysis.
复制标题
人肾同种移植物：临床和病理分析。
作者：
R. Glassock;D. Feldman;E. Reynolds;G. Dammin;J. Merrill
摘要 – 人肾同种移植物：临床和病理分析 作者：Glassock, R.J.；费尔德曼，D.；雷诺兹，E.S.；达明，G.J.和 Merrill, J.P.：医学 47：411 (1968)。这份报告记录了 Peter Bent Brigham 医院超过 13 年的经验，其中 22 名患者接受了同卵双胞胎的肾移植手术。十七名接受者有肾小球肾炎的临床和形态学证据。在撰写本文时，有 11 名患者在同种移植的肾脏中出现了类似疾病的复发。对原发疾病的临床和形态学研究确定了具有高复发风险的患者的特征。复发性肾小球肾炎的临床特征是蛋白尿和血尿，并且通常随后发展为肾病综合征和进行性肾衰竭。肾小球细胞增多是与复发相关的最常见的组织学病变。系膜增厚可观察到有或没有复发的临床证据。免疫球蛋白G、β1c球蛋白和纤维蛋白原的肾小球沉积与疾病复发相关。通过电子显微镜观察，可见内皮下和上皮下沉积物。作者得出的结论是，同种肾移植受者的复发性肾小球肾炎很可能是导致移植的原始疾病的相同潜在过程的表现。作者地址：R.J.博士Glassock，美国加利福尼亚州托伦斯港综合医院医学部。人同种异体移植肾中免疫球蛋白和纤维蛋白的沉积 作者：McKenzie, I.F.C. Whittingham, S.：《柳叶刀》：1313 (1968)。通过免疫荧光检查来自 28 名同种异体肾移植受者的 82 个肾切片中的免疫球蛋白、补体和纤维蛋白沉积物。在各种尺寸的血管中均检测到 IgM 和 IgG 沉积物，但未检测到 IgA；衬里内皮，向中膜延伸，并在增厚的内膜中的较大血管中。肾小球中也存在线状和粒状沉积物。存在补体和纤维蛋白，但不存在白蛋白或 alpb3⁄4 巨球蛋白。在临床排斥期间检查的 49 个切片中，与 14 个非排斥肾脏的发生率相比，免疫球蛋白、补体和纤维蛋白的数量显着增加。这些沉积物的证明表明体液抗体可能在人类同种异体移植肾的排斥反应中发挥重要作用。作者地址：Dr. I.F.C.麦肯齐，皇家墨尔本医院，维多利亚 3050（澳大利亚）。摘要 – Resumes 629 肾同种移植后醛固酮排泄中的血浆肾素活性 作者：Greene, J.A.；范德，A.J.和 Kowalczyk, R.S.：J. Lab。和临床。医学。 71：586（1968）。本研究的目的是评估去肾神经对肾素对钠限制和直立姿势反应的影响。研究人员对三名一年或一年以上接受同种肾移植的患者及其肾脏捐赠者进行了研究。此外，一名受者在肾移植两个月后接受了调查。所有患者均被置于
Summaries – Résumés Human renal isografts: A clinical and pathological analysis By Glassock, R.J.; Feldman, D.; Reynolds, E.S.; Dammin, G.J. and Merrill, J.P.: Medicine 47: 411 (1968). This report documents Peter Bent Brigham Hospital experience over 13 years with 22 patients receiving renal transplants from their presumed identical twin. Seventeen of the recipients had clinical and morphological evidence of glomerulo-nephritis. At the time of this writing, eleven had developed a recurrence of a similar disease in the isotransplanted kidney. Clinical and morphologic studies of the original disease identified the characteristics of patients carrying a high risk of recurrence. Recurrent glomerulonephritis was clinically characterized by protein-uria and hematuria and often by the subsequent development of the nephrotic syndrome and progressive renal failure. Glomerular hypercellularity was the most common histologic lesion associated with recurrence. Mesangial thickening was seen with and without clinical evidence of recurrence. Glomerular deposition of immunoglobulin G., Beta lc globulin and fibrinogen was associated with recurrent disease. By electronmicroscopy both subendothelial and subepithelial deposits were seen. It is concluded by the authors that recurrent glomerulonephritis in the recipient of renal isografts is most likely a manifestation of the same underlying process responsible for the original disease which led to transplantation. Author’s address: Dr. R.J. Glassock, Department of Medicine, Harbor General Hospital, Torrance, CA (USA). Deposits of immunoglobulin and fibrin in human allografted kidneys By McKenzie, I.F.C. and Whittingham, S.: Lancet it: 1313 (1968). Eighty-two kidney sections from 28 human recipients of renal allografts were examined by immunofluorescence for deposits of immunoglobulin, complement and fibrin. Deposits of IgM and IgG, but not IgA were detected in vessels of all sizes; lining the endothelium, extending towards the media, and in larger vessels in the thickened intima. Linear and granular deposits were also present in glomeruli. Complement and fibrin were present but not albumin or alpb3⁄4macroglobulin. Of 49 sections examined during clinical rejection, immunoglobulin, complement and fibrin were demonstrated in a significant number when compared with the incidence in 14 non-rejecting kidneys. The demonstration of these deposits suggests that humoral antibodies may play an important role in the rejection of human allografted kidneys. Author’s address: Dr. I.F.C. McKenzie, Royal Melbourne Hospital, Victoria 3050 (Australia). Summaries – Resumes 629 Plasma renin activity in aldosterone excretion, after renal homotransplantation By Greene, J.A.; Vander, A.J. and Kowalczyk, R.S.: J. Lab. and clin. Med. 71: 586 (1968). This study was performed to evaluate the effects of renal denervation on the renin response to sodium restriction and to the upright posture. Three patients who received renal homotransplantation 1 year or more previously, and their kidney donors were studied. Also, one recipient was investigated two months after renal transplantation. All patients were placed on a