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供肾活组织检查在组织病理学评估中的应用及展望

黄焕文 赖彦华

黄焕文, 赖彦华. 供肾活组织检查在组织病理学评估中的应用及展望[J]. 器官移植, 2019, 10(2): 206-208. doi: 10.3969/j.issn.1674-7445.2019.02.016
引用本文: 黄焕文, 赖彦华. 供肾活组织检查在组织病理学评估中的应用及展望[J]. 器官移植, 2019, 10(2): 206-208. doi: 10.3969/j.issn.1674-7445.2019.02.016
Huang Huanwen, Lai Yanhua. Application and prospect of donor kidney biopsy in the histopathological evaluation[J]. ORGAN TRANSPLANTATION, 2019, 10(2): 206-208. doi: 10.3969/j.issn.1674-7445.2019.02.016
Citation: Huang Huanwen, Lai Yanhua. Application and prospect of donor kidney biopsy in the histopathological evaluation[J]. ORGAN TRANSPLANTATION, 2019, 10(2): 206-208. doi: 10.3969/j.issn.1674-7445.2019.02.016

供肾活组织检查在组织病理学评估中的应用及展望

doi: 10.3969/j.issn.1674-7445.2019.02.016
基金项目: 

广西医疗卫生适宜技术开发与推广应用项目 S2018086

广西自然科学基金项目 2017GXNSFDA198051

详细信息
    作者简介:

    黄焕文,男,1990年生,硕士,住院医师,研究方向为肾移植与移植免疫,Email: 1114702663@qq.com

    通讯作者:

    赖彦华,男,1978年生,博士,副主任医师,研究方向为器官移植与临床,Email: 1379771812@qq.com

  • 中图分类号: R617, R361

Application and prospect of donor kidney biopsy in the histopathological evaluation

  • 摘要: 供肾质量是影响肾移植疗效的重要因素之一,供肾移植前活组织检查(活检)为器官分配及术后免疫抑制方案选择提供组织病理学依据,不同组织学病变情况产生不同的移植效果。本文综述了冰冻切片病理和石蜡切片病理在供肾活检中的应用,阐述了它们在组织病理学评估中的优缺点及显微成像技术应用于供肾评估潜力的展望。旨在寻求一种精准的供肾组织病理学评估手段,在最大化提高器官利用率的同时,将移植肾功能不全发生率降到最低。

     

  • 表  1  3大常用病理评分系统比较

    Table  1.   Comparison of three common pathological scoring systems

    评分系统 提出时间 概述 优点 缺点
    Remuzzi评分 1999年 评估肾小球纤维化的百分比、肾小管萎缩、间质纤维化和血管内膜增厚等各种组织的病变程度 决定单肾移植(< 3分), 双肾移植(4~6分)或弃用(≥7分) 与移植物存活无相关性
    Banff评分 2000年提出后持续更新至2017年 评估肾小球硬化、肾小球系膜基质增生、小动脉血管硬化剂玻璃样变、肾小管萎缩及肾间质纤维化 根据不同的形态表现, 对术前供肾慢性肾损伤进行评分及分类 组织学参数与移植物结局无关
    MAPI 2008年 评估肾小球硬化百分比、小叶间动脉两对侧管壁厚度和管腔直径比值、肾小球周围纤维化、小动脉透明变性及瘢痕程度 可评估供肾质量及预测移植预后级别(高风险及低风险) 可能会忽略部分ECD供肾
    下载: 导出CSV
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出版历程
  • 收稿日期:  2018-12-27
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2019-03-15

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