脑死亡供体肾脏病理改变及移植应用标准评判的探讨  

Feasibility of using the kidney from brain-death donor for renal transplantation

作　　者：农江[1] 孙煦勇[1] 秦科[1] 赖彦华[1] 聂峰[1] 董建辉[1] 文海涛[1] 李壮江[1] 杨建均[2] 何昌桓[2] 

机构地区：[1]中国人民解放军第三0三医院移植医学研究院,广西南宁530021 [2]中国人民解放军第三0三医院病理科,广西南宁530021

出　　处：《热带医学杂志》2011年第3期303-305,F0004,共4页Journal of Tropical Medicine

基　　金：广西自然科学基金(0991288)

摘　　要：目的探讨脑死亡供体肾脏病理改变及对临床使用的指导意义。方法对13例脑死亡供体26个肾脏进行了穿刺活检,做HE染色、网状纤维染色及PAS染色。结果发现大多数患者均有不同程度的近曲小管坏死,而远曲小管、肾小球、基底膜多无改变。选择肾近曲小管上皮细胞坏死<50%、肾小球无明显改变、肌酐<250μmol/L、年龄<55岁的供体26个肾脏施行了移植,均取得成功。结论脑死亡供体肾脏根据穿刺病理活检改变并结合临床表现可以作为临床移植的评判依据。Objective To investigate the pathological appearance of kidney from the brain death donors,so as to evaluate the feasibility of using the kidney for renal transplantation from brain death donors.Methods HE,PAS and Gomori staining were employed to evaluate the degree of pathological changes of kidneys from 13 brain death donors.Results Various degree of proximal convoluted tubule necrosis were observed in kidneys from most of brain death donors,while the renal pathological changes of distal convoluted tubule,kidney glomerulus and basilar membrane were not observed.All of the 26 kidneys with less than 50% proximal convoluted tubule necrosis,intact kidney glomerulu,and less than 250 μmol/L of serum creatinine were successfully transplanted into receipts.Conclusion Renal pathological appearance of kidneys from the brain death donor can be used as criteria for the assessment of the kidney before renal transplantation.

关 键 词：脑死亡 肾移植 近曲小管 

分 类 号：R365[医药卫生—病理学]