Differential Analysis Of Frozen Pathology And Paraffin Section Of DCD Donor Kidney Biopsy And Its Guiding Significance For Renal Transplantation Prognosis

Objective:Compare the differences between zero-point biopsy frozen sections and paraffin-embedded sections and its guiding significance for the prognosis of renal transplantation.Method:For the zero-point frozen biopsy of the kidneys from June 2016 to June 2018,the kidney biopsy specimens were placed directly on the cryostat and frozen and sliced in parallel,then immediately given to hematoxylin-Eosin(HE)and other staining,the remaining tissue was embedded in paraffin,and the biopsy specimen was fixed by formaldehyde fixative,and then made into parafSin-embedded sections by rapid tissue dehydration and waxing,and then stained and treated.The same pathologist performed the reading and Remuzzi scores,two groups of low and high groups,of which the frozen group for renal tissue lesions ranged from 0-6 points,low grouped 0-3 points,and high grouped 4-6 points..The scores of renal tissue lesions in the paraffin group ranged from 0 to 7 points,the low group was 0-3 points,and the high group was 4-7 points.The general condition and postoperative recovery of the corresponding recipients were collected,according to the two groups.Comparison between groups,analysis of the difference between the two pathological evaluation methods and the guiding significance of postoperative DGF and eGFR prediction.Result:1.Among 151 donor kidneys and recipients,the scores of renal tissue lesions in the frozen group ranged from 0 to 6 points,145 cases(96.03%)in the low group,and 6 cases(3.97%)in the high group.The scores of renal tissue lesions in the paraffin group ranged from 0 to 7 points,141 cases(93.38%)in the low group,and 10 cases(6.62%)in the high group.Whether it is frozen section or paraffin section,the total score is mainly low segmentation.2.The incidences of low-grade and high-group DGF in frozen section and paraffin section were 47.59%,50.00%,46.81%,and 60.00%,respectively.The difference was not obvious,and the difference was not statistically significant(P>0.05).;3.The incidence of DGF in the low-group and high-group frozen and paraffin-embedded sections for renal pathology scores were 47.59%and 46.81%,50.00%,and 60.00%,respectively.There was no significant difference between the two groups.The difference was not statistically significant.(P>0.05).4.Compared with high grouping,the pathological scores of frozen sections were not significantly different from those of 7 days and 1 month after operation.There was no significant difference(P>0.05),and the difference of eGFR between March and June after operation.Obviously,the difference was statistically significant(P<0.05).5,the paraffin section low group compared with the high group,the eGFR difiference in 7 days,1 month,3 months,and 6 months after surgery,the pathological score and the difference of eGFR between 7 days,1 month,and 3 months after surgery were not obvious.There was no significant difference between the two groups(P>0.05),and there was significant difference between the two groups(p<0.05).6.There was no significant difference in eGFR between the frozen section and the high-group frozen section and the paraffin section for 7 days,1 month,1 month,3 months and 6 months after the renal pathological score.There was no significant difference(P>0.05).7.The correlation between the renal pathological score and the eGFR at 7 days,1 month,3 months,and 6 months afrter surgery was weak and basically irrelevant.Conclusion:1.The total kidney supply in the DCD era is mainly based on Remuzzi scores of 0,1,and 2 points,and the total score is mainly low-level;2.The pathological scores of frozen biopsy frozen sections and paraffin sections were less predictive of postoperative DGF and other complications,and the differences between the two groups were not obvious.3.The scores of frozen sections and paraffin sections can reflect the recovery of postoperative glomerular filtration rate to a certain extent.The predictive value of eGFR in the two groups is especially significant at 6 months after surgery.Recovery has a certain predictive value.4.The correlation between the renal pathological score and the eGFR at 7 days,1 month,3 months,and 6 months after surgery was weak,and it was basically irrelevant.5.kidney zero biopsy can effectively assess the quality of the kidney,need to further improve the biopsy technology and uniform evaluation of the extent of the disease.