A Preliminary Study Of Biopsy And Early Renal Function After Transplantation

Objective:To analyze the clinicopathological data of donation kidney after the death of citizens,and to explore prognostic indicators for renal function after transplantation.Methods:The clinical and pathological data of 227 recipients who underwent unilateral renal transplantation in the Department of Organ Transplantation,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2014 to November 2016 were retrospectively analyzed.Standard demographic and clinicopathological data were collected from our database.Follow-up was conducted by telephone,network platform,and return to hospital review.The latest follow-up time was July 31,2018.Results:The average age of the recipients was 42.4 ± 10.7 years(range: 20-74 years).The incidence of DGF was 23.5%.The average age of the donor was 44.2 ± 14.2 years(range: 4-73 years);the donor of cerebrovascular death accounted for 41.4%.The average cold ischemia time was 7.6 ± 3.7 h(range: 2.0-23.7 h).The average e GFR value of the recipients after surgery was 62.8±18.7 m L/(min×1.73 m2),and the postoperative year was 69.4±17.4 m L/(min×1.73 m2).In the three months after surgery,21.5% of the recipients had serum e GFR values < 50 m L/(min×1.73 m2),and 12.1% of the recipients had a serum e GFR value < 50 m L/(min×1.73 m2).The average ratio of all glomerular sclerosis in the kidney was 9.7 ± 13.9%.Among them,36.6% of glomerular sclerosis ratio was >10%,and 19.8% of glomerular sclerosis ratio was >20%.Univariate logistic regression analysis showed donor age,arterial intimal sclerosis,aortic glassy change,renal interstitial inflammation,renal interstitial fibrosis,and glomerular sclerosis.Multivariate regression analysis showed that arterial intimal sclerosis was an independent predictor of short-term renal function after transplantation.Recipient age was an independent predictor of long-term renal function after transplantation.Conclusions:The degree of arterial intimal sclerosis is superior to the prediction of early renal function after transplantation,which is superior to the glomerular sclerosis ratio.It provides a new idea for the evaluation of donor kidney quality before transplantation and even for kidney distribution.