供肾质量和移植肾急慢性排斥反应关系分析

目的探讨影响供肾质量的因素与术后移植肾发生急、慢性排斥反应的相关性。方法观察87例移植供肾缺血时间、活检组织的光镜表现结合移植后发生急、慢性排斥反应的情况进行分析。结果移植术后跟踪3年．发生移植肾急性排斥反应28例，其中5例(17．8％)有供肾组织有不良改变；慢性排斥反应13例，其中6例(46．1％)有供肾组织有不良改变。采用Logistic回归分析，结果示冷缺血时间、肾小管损伤是急性排斥反应的危险因素；冷缺血时间、肾小球硬化是慢性排斥反应的危险因素，与慢性移植病的发生可能相关。结论提高供肾质量和减少上述的危险因素．对减少肾移植术后急慢性排斥反应的发生是有意义的。

Relationship between donor renal graft quality and graft rejection]

OBJECTIVE: To evaluate the correlation between the quality of donor renal grafts and graft rejection. METHODS: The cold ischemia time and the pathological findings by biopsies of the donor grafts in 87 cases were analyzed in conjunction with the occurrence of acute or chronic graft rejection after transplantation. RESULTS: After transplantation, acute rejection occurred in 28 cases, in which 5 (17.8%) had adverse changes in the donor grafts; chronic allograft nephropathy developed in 13 cases, in which 6 (46.1%) had adverse changes in the donor grafts. By binary logistic regression analysis, the cold ischemia time and acute renal tubular injury were identified as the factors affecting acute graft rejection, and cold ischemia time and glomeruloserosis as the risk factors for chronic rejection. CONCLUSION: High-quality donor kidney and minimization of the risk factors help reduce the occurrence of graft rejection after kidney transplantation.