关键词: 心脏死亡器官捐献, 肾移植, 零点活检

Abstract:

Ｏｂｊｅｃｔｉｖｅ：To investigate the effect of common chronic lesions in donation after cardiac death（DCD）donors timezero renal biopsy(TORBx) specimens on the allografts function early after kidney transplantation.
Ｍｅｔｈｏｄｏｌｏｇｙ：Fiftyfour TORBx specimens from DCD donors obtained at Jinling hospital from January,2011 to June,2017 were retrospectively reviewed.According to the 2007 Banff criteria,common chronic pathologic changes including global glomeruloscerosis(GS),chronic tubular atrophy(CT),chronic interstitial fibrosis(CI),arteriolar hyaline thickening(AH) and chronic vascular fibrous intimal thickening(CV) were respectively scored.The difference of pathologic changes between donors died of cerebral hemorrhage or trauma was evaluated.The effect of different lesions on allografts′ function was investigated during 6 months after renal transplantation.
Ｒｅｓｕｌｔｓ：Of all 54 TORBx specimens,26 cases（4815%）with GS,among them 23 were mild change and 3 were moderate change; 17 cases(3148%) with CT,16 were mild change and one was moderate change; 7 cases with CI,and all were mild change; 19 cases(3519%) with AH,18 were mild change and 1 were moderate change; 13 cases with CV,all were mild change.The percentage of GS was higher in donors died from cerebral hemorrhage than in donors died from cerebral trauma(P=0006),and the renal allografts glomerular filtration rate(eGFR) from the former donors were lower than that from the latter donors(P=0047).GS and AH changes all had independent influence on allografts function within 6 months after renal transplantation（P=0031;P=0043）.
Ｃｏｎｃｌｕｓｉｏｎ：
Timezero renal biopsy in DCD donors has predictive value for the allograft function,is one of the instructions for recipients immunosuppressive regiments after renal transplantation.

Key words: donation after cardiac death, kidney transplantation, time-zero renal biopsy