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首页> 外文期刊>Transplantation Proceedings >Analysis of histologic changes during early rejection after renal transplantation by performing protocol biopsy at 1 year after kidney transplantation
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Analysis of histologic changes during early rejection after renal transplantation by performing protocol biopsy at 1 year after kidney transplantation

机译：肾移植后1年进行方案活检分析肾移植后早期排斥反应中的组织学变化

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Background In this retrospective study, we analyzed histologic changes identified through protocol biopsy (PB) at 1 year after kidney transplantation (KT). We focused on the pathologic changes observed in patients with a history of treatment for graft rejection within 1 year of transplantation. Methods Between January 2008 and December 2011, 56 patients underwent KT at our center. We assessed the histologic findings observed at 1 year after renal transplantation using the Banff 2007 classification. At our center, PBs are performed immediately after or at 1 hour after transplantation, and at 1 year after KT. PBs were performed in 39 patients; PBs could not be performed in 17 patients because of various causes. Of the 39 patients, 29 stabilized without clinical rejection and without treatment (the NTx group); 10 patients showed pathologic changes or clinical rejection after steroid pulse therapy within 1 year (the Tx group). We compared these 2 groups with respect to baseline data, renal function, and pathologic scores. Results The interstitial fibrosis ("ci") score, according to the Banff classification, was significantly greater in the NTx group (0.89) than in the Tx group (0.50) at 1 year after transplantation. Conclusions The currently applied early steroid withdrawal regimen may be not be ideal for preventing pathologic changes occurring after KT. In addition to the PB performed 1 year after KT, PB should be performed within 1 year of renal transplantation to identify early signs of rejection and to provide access to appropriate treatment regimes.
机译：背景在这项回顾性研究中，我们分析了肾脏移植（KT）后1年通过方案活检（PB）鉴定的组织学变化。我们重点研究了在移植后1年内有移植排斥反应治疗史的患者中观察到的病理变化。方法在2008年1月至2011年12月期间，有56例患者在我们中心接受了KT手术。我们使用Banff 2007分类评估了肾移植术后1年观察到的组织学发现。在我们中心，PB是在移植后或移植后1小时以及KT术后1年进行的。 PB进行了39例患者。由于各种原因，无法在17例患者中进行PBs。在39例患者中，有29例在没有临床排斥反应和未经治疗的情况下稳定下来（NTx组）; 1年内接受类固醇脉冲治疗后有10例患者出现病理改变或临床排斥反应（Tx组）。我们比较了这两组的基线数据，肾功能和病理评分。结果根据Banff分类，在移植后1年，NTx组的间质纤维化（“ ci”）评分（0.89）明显高于Tx组（0.50）。结论当前应用的早期类固醇激素戒断方案可能不是理想的预防KT后发生病理改变的方法。除了在KT术后1年进行PB之外，还应在肾移植后1年内进行PB，以发现排斥反应的早期迹象并提供适当的治疗方案。

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