老龄供肾在青年受者体内的病理学改变  

Pathological changes of renal grafts from elderly donor kidney in young recipients

作　　者：方佳丽[1] 陈正[1] 马俊杰[1] 李光辉[1] 徐璐[1] 张磊[1] 郭予和 张异蕊 潘光辉[1] 

机构地区：[1]广州医科大学附属第二医院移植科,510260

出　　处：《器官移植》2015年第5期335-339,共5页Organ Transplantation

摘　　要：目的研究老龄供肾在青年受者体内的病理学改变,探讨老龄供肾移植的安全性。方法研究对象选择2008年1月至2008年12月期间在广州医科大学附属第二医院移植科实施亲属活体供肾移植的14例老龄供者(年龄>55岁)和14例青年受者(年龄<30岁)。对每例老龄供肾进行零时活组织检查(活检),对接受老龄供肾的青年受者在移植后6个月进行常规的移植肾活检。观察老龄供肾移植后的肾脏组织病理结构改变。结果老龄供肾移植至青年受者体内6个月后组织病理结构发生改变:肾小动脉病变程度较移植前减轻;肾小动脉硬化指数较移植前减轻(P<0.05);肾小球硬化比例移植前后变化不大(P>0.05)。纤维连接蛋白(FN)水平较移植术前表达水平降低,但差异无统计学意义(P>0.05);层黏连蛋白(LN)表达水平较移植前降低(P<0.05)。结论老龄供肾移植到青年受者体内后,其组织病理学结构有所改善。Objective To study the pathological changes of renal grafts from elderly donor in young recipients and to investigate the safety of kidney transplantation from elderly donors.Methods Fourteen elderly kidney donors （with the age 〉55 years old）and fourteen young recipients （with the age 〈30 years old）underwent living related donor renal transplantation at the Department of Transplantation of the Second Affiliated Hospital of Guangzhou Medical University from January 2008 to December 2008 were enrolled as the object of study.Every elderly donor kidney was performed time-zero biopsy and every young recipient was performed routine renal graft biopsy 6 months after transplantation.The pathological and structural changes of kidney tissues after renal transplantation from elderly donors were observed.Results The histopathological changes occurred at 6 months after transplantation from elderly kidney donors to young recipients.Compared with those before transplantation,the severity of renal arteriolar lesion and the index of renal arteriolar sclerosis alleviated after transplantation （P 〈0.05 ）, and the ratio of glomerulosclerosis did not change after transplantation （P 〉0.05 ）.The expression of fibronectin （FN）decreased after transplantation,but the difference had no statistical significance （P 〉0.05 ）.The expression of laminin （LN ） decreased after transplantation （P 〈0.05）.Conclusions The histopathological structure of renal graft from elderly donors in young recipients has improved.

关 键 词：活体肾移植 年龄 供者 肾小球硬化 肾间质纤维化 细胞外基质 

分 类 号：R617[医药卫生—外科学]