Morphological Data after Receiving and Transplanting Donor Kidney National Scientific

Abstract

Introduction: Optimal treatment of patients with terminal CKD is heterotopic allotransplantation of donor kidneys. The result of treatment depends on the quality of received donor kidneys. We compared the morphological data of donor kidney biopsies exposed to ischemia in the donor and conditioning stages of alternative conservation. Material: 74 kidneys were obtained from asystolic donors in hospitals of Almaty, Republic of Kazakhstan from 2000 to 2009. Mean age of donors 35 (±4,3) average 25 - 45 years. hemodynamic status of donors was maintained by Dopamine in different dosage. Morphological data were investigated by light microscopy (×400 and 1000) at the period 5th and 21st POD. Results: 28 kidneys were conditioned in patients with Dopamine 5mkg/kg/min, 46 kidneys in 10mkg/kg/min. 52 kidneys were conserved by Custodiol only and 22 by the combination of saline with heparin (ratio 1:100) first and then by Custodiol. From 52 kidneys conserved by Custodiol 28 were received with dopamine dosage 5mkg/kg/min - Group I. Latter 24 kidneys were obtained in Dopamine 10mkg/kg/min - Group II. 22 kidneys were conserved first by saline with heparin (1:100) and then by Custodiol. Dopamine dosage was 10mkg/kg/min - Group III. Morphological data of kidney biopsies at 5th POD in group I and III was simlar: fibering of basal membranes in nephrotelium of convoluted tubule. Vessels are plethoric, nuclei are hyperchromatical, condensation of chromatin in the nucleus is expressed. Interstitial tissue is plethoric. isolated lymphocytes are found in the perivascular space. Group II: a swelling of the interstitial tissue, perivascularly isolated cells and pamaquines. Nephrotelium of convoluted tubule is high. At the 21st POD morphologic data of group I and III were also similar: rotundity of lumen of convoluted tubules are lined by high nephrotelium, the nuclei are displaced to the basal membrane. The condensation of chromatin in the nuclei is central, basal membrane is clear, capillary vessels are lined by flattened endothelium. Vascular glomeruli are presented by loops of capillary vessels. There is proliferative activity of podocytes and light dystrophy of mezangiocytes. Group II: glomeruli and blood vessels of interstitial tissue are plethoric, swollen endothelium of vessels and moderately narrowed lumen was revealed. Vacuoles are located around the nuclear membrane in the cytoplasm. The basal membrane is fibered, swollen with loss tinctoriality. There is a round-cell infiltration presented by plasma cells and lymphocytes around the glomeruli and vessels. The lumen of the convoluted tubules is reduced due to swelling of nephrotelium. Nephrocytes at the stage of necrobiosis are noticed. Conclusion: the biopsy data in the groups I and III were similar and better compared with group II. The conservation of kidneys from donors with high dosage of dopamine is more preferable by the use of saline with heparin firstly and then Custodiol.