Experimental And Clinical Study On Relationship Between Glomerular Number And Chronic Allograft Nephropathy

Renal transplantation is an effective way to cure end-stage renal disease (ESRD). And short-term survival of renal tranplants rate (STSRTR) has increased up to 95% because of the improvement of HLA-match and immunosupression .But the long-term survival rate of renal transplants (LTSRRT) still has no significantly increase and 10-year survival rate is just about 50%. AH the great transplant centers reported that chronic allograft nephropathy (CAN) was one of the most important cause of renal allograft failure (RAF). So it is quite a matter for clinical doctors to deal with at their best. Now, people pay more attention to the mechanism of CAN than before. And it is agreed that CAN is caused by muM-faetors including alloantigen-depended factors (immune factors) and alloantigen-indenpended factors (non-immune factors). No matter immune factors or non-immune factors, the baas reason why they lead to CAN is glomerular number relative or utterly insufficiency, and non-immune factors play a more important role than immune factors do in the mechanism of CAN.sometimes. Only knowing the changes of glomerular number and glomerular volume, can we halt the progression of CAN, even reverse it and prolong long-term survival rate of renal transplants.Plenty of scientist drew some conclusions after observing those renal allograft tranplants survived many years with stable renal function and contrasting them with those survived not so long. Excluding cold ischemia(CI), warm ischemia(WI) and acute rejection (AR), they found that: The kidneys from the elder and chidren survived shorter than that from adult. (2) Women's kidneys are smaller than men's. The kidney transplanted from a woman to a man survived obviously shorter than that transplanted from a man to a woman. (3) The allografts of fat or high-weight recipients survived shorter than those of normal or low-weight recipients. (4) Allograft with poor blood vessel survived shorter. These facts are observed in our clinical transplantation, too. Moreover, some foreign tranplant centers reported that the kidneys of the yellow were smaller than that of the white, and it didn't survive so long as the white's did. These fact showed: Glomerular number relative or utterly insufficiency is a risk factor to cause CAN and has an affinity with long-term allograftsurvival. But there is still no reports about relationship between glomerular number and CAN.Our experiment want to autotransplant 1/6 kidney in situ (AXIS) to male Wistar rats (1) To build up a CAN model caused by glomerular number insufficiency .This operation will be carried on according the process of renal transplantation. We try to understand the mechanism of CAN through these models, and how glomerular number and glomerular volume change. This model's building can prove how important nonimmune factors are in the mechanism of CAN. (2) To calculate glomerular number and glomerular volume of kidney from different group (group normal, group sigle-kidney and group CAN) by stereological way. And observe the changes of glomerular number and golmerular volume following the decrease of glomerular number. (3) To observe the changes of renal function following the loss of glomerular number. From this we can know the correlationship between glomerular number, glomerular volume and renal function. (4) To observe the renal fibrosis and the expression of cytokines TGF 1 (Transforming Growth Factor 1) PDGF-A (Platelet-Derived Growth Factor A) PDGF-B (Platelet-Derived Growth Factor B) and their acceptors PDGF- a R (Platelet-Derived Growth Factor Receptor- a ) PDGF- R (Platelet-Derived Growth Factor Receptor- ). And try to find the relationship between glomerular number ,glomerular volume and renal fibrosis ,the expression of cytokines and their acceptors. Through them finding the mechanism of CAN, and this will be greatly helpful to slow, halt and reverse CAN. ?In order to apply these results of this experiment in clinical transplantation, we collect Chinese healthy adult's kidneys ,try to master the data of kidneys and analyse the fa...