目的探讨脑死亡供体肾脏病理改变及对临床使用的指导意义。方法对13例脑死亡供体26个肾脏进行了穿刺活检,做HE染色、网状纤维染色及PAS染色。结果发现大多数患者均有不同程度的近曲小管坏死,而远曲小管、肾小球、基底膜多无改变。选择肾近曲小管上皮细胞坏死<50%、肾小球无明显改变、肌酐<250μmol/L、年龄<55岁的供体26个肾脏施行了移植,均取得成功。结论脑死亡供体肾脏根据穿刺病理活检改变并结合临床表现可以作为临床移植的评判依据。 Objective To investigate the pathological changes of the kidneys of the deceased donors and their clinical significance. Methods Twenty-six kidneys from 13 brain death donors were biopsied for HE staining, reticular fiber staining and PAS staining. The results showed that most patients have different degrees of proximal tubule necrosis, and distal tubules, glomerular, basilar membrane no change. Select the renal proximal tubule epithelial cell necrosis <50%, glomerular no significant change, creatinine <250μmol / L, age <55 years of donor 26 kidneys were implanted, were successful. Conclusion Brain death donor kidneys can be used as the basis of clinical transplantation according to biopsy of the puncture pathology combined with clinical manifestations.