实用器官移植电子杂志

实用器官移植电子杂志 ›› 2022, Vol. 10 ›› Issue (4): 342-346.DOI: 10.3969/j.issn.2095-5332.2022.04.010

• 论著 • 上一篇    下一篇

活检取材部位和方法对公民逝世后器官捐献供肾组织病理学评估的影响

陈剑霖，郭晖   

  1. 华中科技大学同济医学院附属同济医院器官移植研究所，器官移植教育部重点实验室，国家卫生健康委员会器官移植重点实验室，中国医学科学院器官移植重点实验室，湖北 武汉 430030

  • 出版日期:2022-07-20 发布日期:2022-09-01
  • 基金资助:

    中国医学科学院中央级公益性科研院所基本科研业务费专项资金资助（2019PT320014） 

Effect of biopsy location and method on histopathological evaluation of donation after citizen's death donor kidney 

Chen Jianlin，Guo Hui.    

  1. Institute of Organ Transplantation，Tongji Hospital，Tongji Medical College，Huazhong Universityof Science and Technology，Key Laboratory of Organ Transplantation，Ministry of Education，NHC Key Laboratory of Organ Transplantation，Key Laboratory ofOrgan Transplantation，Chinese Academy of Medical Sciences，Wuhan 430030，Hubei，China.

  • Online:2022-07-20 Published:2022-09-01

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摘要：

目的 探究不同取材部位和取材方法对公民逝世后器官捐献（donation after citizen's death，DCD）供肾组织病理学评估的影响。方法 收集 2019 — 2022 年华中科技大学同济医学院附属同济医院器官移植研究所的 10例弃用供肾标本。于肾脏不同位置获取活检标本，经石蜡切片及苏木精 - 伊红染色后比较其肾小球和小动脉数量及其病变程度，并根据 Banff 评分、Remuzzi 评分、Maryland 评分以及 Pirani 评分对样本进行模拟评估。然后将标本与获取时穿刺活检标本进行对比，并计算 2 种标本单位面积中肾小球和小动脉数量。结果 不同部位取材的标本中可观察到的肾小球和小动脉数量及病变程度没有差异（P ＞ 0.05），模拟 Banff 评分、Remuzzi 评分、Maryland 评分以及 Pirani 评分均没有显著性差异（P ＞ 0.05）。 穿刺标本的肾小球硬化率（42%±8.8% 比 25%±23.2%）、小动脉内膜增厚比例（68%±27% 比 46.5%±22.8%）和小动脉透明样变比例（86%±17.4% 比 59.3%±16.4%）高于解剖标本。两种标本的供肾评分仅 Banff 评分中的肾小球硬化程度具有显著性差异（2.2±0.4 比 1.6±0.9），其余评分没有显著性差异（P ＞ 0.05）。在单位面积下穿刺标本的肾小球数量小于解剖标本〔（199.3±50.7）个 /cm2 比（240.6±57.4）个 /cm2〕，但是小动脉数量大于解剖标本〔（153.5±76.9）个 /cm2 比（114.9±43.7）个 /cm2〕。结论 从不同部位获取活检标本对DCD 供肾组织学评估没有影响。穿刺活检标本评分结果可以反映供肾病理损伤程度。目前穿刺活检较深，穿刺时应适当减小进针角度。

关键词:

取材部位 , 组织病理学 , DCD 供肾

Abstract:

Objective To explore the effects of different biopsy location and methods on the histopathological evaluation of donation after citizen's death（DCD）donor kidney. Methods Ten cases of discarded donor kidneys were collected from 2019 to 2022. Samples were harvested from different sites and preparedby paraffin section. After being stained with hematoxylin-eosin（HE），the number of glomeruli and arterioles and the degree of lesion were compared. The specimens were evaluated according to Banff score，Remuzzi score， Maryland score and Pirani score. The samples were compared with the other samples collected bycore needle biopsy，and the number of glomeruli and arterioles per unit area of the two samples were calculated. Results There was no difference in the number and degree of glomeruli and arterioles observed in specimens taken from differentparts（P ＞ 0.05），and there was no significant difference in Banff score，Remuzzi score，Maryland score and Pirani score（P ＞ 0.05）. The proportion of glomerulosclerosis（42%±8.8% vs. 25%±23.2%），intimal thickening of arterioles（68%±27% vs. 46.5%±22.8%）and arterioles hyaline degeneration（86%±17.4% vs. 59.3%±16.4%）incore needle biopsy specimens was higher than that in anatomical specimens. In the aspect of donor kidney scoring，only the degree of glomerulosclerosis in Banff score was significantly different between the two samples（2.2 ± 0.4 vs. 1.6 ± 0.9）， and there was no significant difference in other scoring systems（P ＞ 0.05）. The number of glomeruli in core needle

biopsy specimens per unit area was less than that in anatomical specimens〔（199.3±50.7）/cm2 vs.（240.6±57.4）/cm2〕，but the number of arterioles was greater than that in anatomical specimens〔（153.5±76.9）/cm2 vs.（114.9±43.7）/cm2〕. Conclusion The way of obtaining biopsy specimens from different parts had no effect on the histological evaluationof DCD donor kidney. The scoring results of core needle biopsy specimens can reflect the degree of donor kidney lesions. The sample getting from core needle biopsy is deep，and the degree of angle entering the donor kidney should be appropriately decreased. 

Key words:

Sampling sites, Histopathology, DCD donor kidney

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