关键词: 肾移植, 移植病理, 心脏死亡器官捐献供肾

Abstract:

Ｏｂｊｅｃｔｉｖｅ：Using the Pirani scoring system to assess the extent of pathological lesion and to explore the effects of lesions in implantation biopsy on the prognosis of renal grafts from donors after cardiac death(DCD).
Ｍｅｔｈｏｄｏｌｏｇｙ：The kidney donated by DCD in Peoples hospital of Zhengzhou between February 1,2015 to February 1,2017 were  retrospectively reviewed.They were stained with hematoxylineosin (HE) after rapid frozen  and assessed by Pirani scoring system.The pathological results of donor kidney were graded by Pirani pathological score,low score group (0～3 points),high score group (4～6 points). Observation indicators: The prognosis of two groups of renal transplantation patients was compared,such as delayed graft recovery (DGF),postoperative 1st month,12th month,24th month of renal allograft creatinine,and 12～36 months after followup cumulative graft survival rate.
Ｒｅｓｕｌｔｓ：A total of 92 donors and recipients were enrolled in the study. There were 68 patients with low scores(739%,68/92) and 24 patients with high scores(261%,24/92).The overall incidence of DGF was 152%. The incidence of DGF in low group and in high group was 70%（5/68）and 375%（9/24）,respectively（P=0028).The mean serum creatinine(SCr) levels at 1st month,12th month,24th month after operation were 1049±168 μmol/L,949±167 μmol/L，and 918±93 μmol/L in low group,and 1162±344 μmol/L,1165±149 μmol/L and 1117±102 μmol/L in high group,respectively.The mean SCr levels in patients at different time points within two years after posttransplantation in low score group were lower than those in high score group (P=0041,P=0044,P=0038,P<005 respectively).After 12～36 months of followup,Kaplanmeier analysis showed no significant difference in survival rate between high and low groups.
Ｃｏｎｃｌｕｓｉｏｎ：The higher the Pirani score of renal pathology,the higher the incidence of DGF after renal transplantation,the shortterm renal allograft function was worse,but there was no significant difference in shortterm survival rate (2 years).

Key words: kidney transplantation, implantation biopsy, cardiac death donor