ヤニシ マサアキ   YANISHI MASAAKI
  矢西 正明
   所属   関西医科大学  腎泌尿器外科学講座
   職種   准教授
論文種別 原著(症例報告除く)
言語種別 英語
査読の有無 査読あり
表題 Correlation of whole kidney hypertrophy with glomerular over-filtration in live, gender-mismatched renal transplant allografts
掲載誌名 正式名:Nephrology
略  称:Nephrology
ISSNコード:13205358/14401797
掲載区分国外
巻・号・頁 22(12),pp.1002-1007
著者・共著者 Yanishi M, Tsukaguchi H, Huan N T, Koito Y, Taniguchi H, Yoshida K, Mishima T, Sugi M, Kinoshita H, Matsuda T
担当区分 筆頭著者
発行年月 2017/12
概要 Optimizing nephron supply to recipient demand is a non-immunologic determinant of renal allograft outcome. Nephron reduction is usually caused by physical donor-recipient mismatch, but its pathologic relevance remains to be determined.
METHODS:
Thirty-one recipients of living donor renal transplants were divided into three subgroups: those who received transplants from the same gender (n = 6, Group 1) and those who underwent male-to-female (n = 8, Group 2) and female-to-male (n = 17, Group 3) transplants. Renal mass was evaluated by three-dimensional computed tomography (3D-CT) volumetry before and one year after transplantation. Glomerular volume was determined from protocol biopsies obtained one hour and one year after transplantation.
RESULTS:
Histologically determined glomerular volume in biopsied tissues showed a significant linear correlation with allograft size on 3D-CT volumetry (p < 0.001, r = 0.625). Mismatches in body weight, glomerular volume and kidney volume ratios were significantly greater in female-to-male (Group 3) than in male-to-female (Group 2) transplants (p < 0.001 each). Despite the two groups having nearly equal graft filtration rates one year after transplantation, proteinuria rate was three-fold higher in Group 3 than in Group 2 (p < 0.001).
CONCLUSION:
These findings suggest that too small graft size, frequent in female-to-male transplants, could cause hypertrophy in both kidneys and glomeruli, thereby affecting allograft function and survival. This article is protected by copyright. All rights reserved.
DOI 10.1111/nep.12915
文献番号 27576505
PMID 27576505