دورية أكاديمية
[Mid-term efficacy evaluation of ABO incompatible living relative kidney transplantation based on protocol biopsy].
العنوان: | [Mid-term efficacy evaluation of ABO incompatible living relative kidney transplantation based on protocol biopsy]. |
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المؤلفون: | Chen HW; Organ Transplantation Center of the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China., He Y; Organ Transplantation Center of the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China., Ruan HH; Organ Transplantation Center of the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China., Wu GB; Organ Transplantation Center of the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China., Yu SJ; Organ Transplantation Center of the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China., Wang Y; Organ Transplantation Center of the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China., Chen GD; Organ Transplantation Center of the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China., Qiu J; Organ Transplantation Center of the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China., Wang CX; Organ Transplantation Center of the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China., Chen LZ; Organ Transplantation Center of the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China. |
المصدر: | Zhonghua yi xue za zhi [Zhonghua Yi Xue Za Zhi] 2024 Mar 26; Vol. 104 (12), pp. 944-949. |
نوع المنشور: | English Abstract; Journal Article |
اللغة: | Chinese |
بيانات الدورية: | Publisher: Zhonghua yi xue hui Country of Publication: China NLM ID: 7511141 Publication Model: Print Cited Medium: Print ISSN: 0376-2491 (Print) Linking ISSN: 03762491 NLM ISO Abbreviation: Zhonghua Yi Xue Za Zhi Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Beijing : Zhonghua yi xue hui Original Publication: Beijing : Zhonghua yi xue hui. |
مواضيع طبية MeSH: | Kidney Transplantation*, Male ; Female ; Humans ; Young Adult ; Adult ; Middle Aged ; Retrospective Studies ; Blood Group Incompatibility ; Kidney ; Living Donors ; Biopsy ; ABO Blood-Group System ; Graft Survival ; Graft Rejection/epidemiology |
مستخلص: | Objective: To evaluate the mid-term efficacy of ABO incompatible living donor kidney transplantation (ABOi-KT) based on the results of routine renal biopsy for transplantation. Methods: Retrospective collection of clinical data from 23 pairs of ABOi-KT donors and recipients at the First Affiliated Hospital of Sun Yat-sen University from July 2015 to November 2021. ABOi-KT was performed on recipients after desensitization treatment, and the results of routine kidney transplant biopsy at 1 week, 1 month, 3 months, 6 months, and 12 months after surgery were analyzed. Combined with blood type antibody levels and renal function recovery, the mid-term efficacy of ABOi-KT was evaluated. Results: Among the 23 recipients, there were 19 males and 4 females; age range from 19 to 47 years old [(29.6±6.7) years old], all underwent ABOi-KT successfully after receiving desensitization treatment. The follow-up time was (44.6±22.4) months, of which 22 cases were followed up for more than 1 year. The incidence rates of rejection reactions at 1 week, 1 month, 3 months, 6 months, and 12 months after surgery were 15.0% (3/20), 11.1% (1/9), 7.7% (1/13), 25.0% (3/12), and 12.5% (1/8), respectively. For receptors with rejection reactions, targeted anti-rejection therapy was performed based on clinical symptoms and various indicators. Borderline T cell mediated rejection (TCMR) can be converted to mild tubular inflammation after anti-rejection treatment. The positive rate of complement C4d in peritubular capillaries was 95.0% (19/20) one week after surgery, and the positive rate of complement C4d was 100% at 3 and 12 months after surgery. The cumulative survival rates at 1, 3, 5, and 7 years after surgery were all 100%. The cumulative survival rates at 1, 3, 5, and 7 years after kidney transplantation were 100%, 93.3%, 84.0%, and 84.0%, respectively. Except for 2 recipients who underwent transplantation in 2017 and experienced kidney failure at 30 and 49 months after surgery, all other transplanted kidneys survived. Conclusions: The results of routine renal transplant biopsy show that ABOi-KT has a good mid-term therapeutic effect. The pathological changes of ABOi-KT can be dynamically observed through routine renal transplant biopsy and targeted treatment for rejection reactions can be provided accordingly. |
معلومات مُعتمدة: | 2020B1212060026 Guangdong Provincial Science and Technology Plan Project |
فهرسة مساهمة: | Local Abstract: [Publisher, Chinese] 目的: 依据程序性移植肾穿刺活检结果对ABO血型不相容活体亲属肾移植(ABOi-KT)的中期疗效进行评价。 方法: 回顾性收集中山大学附属第一医院2015年7月至2021年11月实施的23对ABOi-KT的供受体临床资料,对受体进行脱敏治疗后行ABOi-KT,分析受体术后1周、1个月、3个月、6个月和12个月程序性移植肾穿刺活检结果,结合血型抗体水平、肾功能恢复情况,对ABOi-KT的中期疗效进行评价。 结果: 23例受体中,男19例,女性4例;年龄19~47(29.6±6.7)岁,均在接受脱敏治疗后顺利实施ABOi-KT。随访时间(44.6±22.4)个月,其中随访时间超过1年者22例。术后1周、1个月、3个月、6个月和12个月病理证实排斥反应的发生率分别为15.0%(3/20)、11.1%(1/9)、7.7%(1/13)、25.0%(3/12)和12.5%(1/8)。对于排斥反应的受体,结合临床症状及各项指标行针对性抗排斥治疗,临界性T细胞介导的排斥反应(TCMR)经抗排斥治疗后均可转为轻度小管炎。术后1周管周毛细血管补体C4d阳性率为95.0%(19/20),术后3和12个月时补体C4d阳性率均为100%。受体术后1、3、5和7年生存率均为100%。移植肾术后1、3、5和7年存活率分别为100%、93.3%、84.0%和84.0%,除2017年进行移植的2例受体于术后30和49个月出现移植肾失功外,其余移植肾均存活。 结论: 程序性移植肾穿刺活检结果显示,ABOi-KT的中期疗效良好,可动态观察ABOi-KT病理改变,并对排斥反应行针对性治疗. |
المشرفين على المادة: | 0 (ABO Blood-Group System) |
تواريخ الأحداث: | Date Created: 20240321 Date Completed: 20240325 Latest Revision: 20240325 |
رمز التحديث: | 20240325 |
DOI: | 10.3760/cma.j.cn112137-20230719-00030 |
PMID: | 38514343 |
قاعدة البيانات: | MEDLINE |
تدمد: | 0376-2491 |
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DOI: | 10.3760/cma.j.cn112137-20230719-00030 |