ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2023, Vol. 32 ›› Issue (3): 286-290.DOI: 10.3969/j.issn.1006-298X.2023.03.018

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移植肾血栓性微血管病的发病机制和诊疗进展

  

  • 出版日期:2023-06-28 发布日期:2023-07-01

Advances in pathogenesis, diagnosis and treatment of thrombotic microangiopathy in transplanted kidney

  • Online:2023-06-28 Published:2023-07-01

摘要: 移植肾血栓性微血管病(TMA)是肾移植术后的一种致死性并发症,严重影响肾移植受者和移植肾的长期生存。移植肾TMA可分为新发性TMA和复发性非典型溶血性尿毒综合征(aHUS),前者更为常见且预后更差。移植肾TMA的临床表现多种多样,且缺乏特异性的检测手段,确诊主要依赖肾组织活检,目前对其仍缺乏疗效确切的精准个体化治疗方案。本文拟综述移植肾TMA的发病机制和诊疗的研究进展,为今后移植肾TMA的诊断及治疗提供新思路。


关键词: 肾移植, 血栓性微血管病, 依库珠单抗, 并发症

Abstract: Thrombotic microangiopathy (TMA) is a lethal complication of renal transplantation that severely affects the long-term survival of the renal transplant recipient and the transplanted kidney. Transplant renal thrombotic microangiopathy can be divided into de novo TMA and recurrent atypical haemolytic uremic syndrome (aHUS). De novo TMA is more common and has a worse prognosis than recurrent aHUS. At this stage, the clinical manifestations of TMA in transplanted kidneys are varied and specific tests are lacking. Therefore, the diagnosis of TMA in transplanted kidneys relies heavily on kidney tissue biopsy. No precise individualised treatment protocols with proven efficacy have been studied. This paper reviews the recent research progress in the pathogenesis and treatment of TMA in transplanted kidneys, providing new ideas for the accurate diagnosis and effective treatment of TMA in transplanted kidneys in the future.


Key words: kidney transplantation, thrombotic microangiopathy, eculizumab, complications