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ドナーの脳死による心臓の活性化により,移植後の急性拒絶が加速されます
M J Wilhelm1, J Pratschke, F Beato
1Surgical Research Laboratory, Harvard Medical School and the Department of Surgery, Brigham and Women's Hospital, Cambridge, Massachusetts, USA.
Circulation
|November 9, 2000
まとめ
臓器提供者の脳死は心臓移植の拒絶を加速する. ドナー心臓の炎症的変化は免疫反応を誘発し,受容者の急性拒絶がより速く,より強烈になる.
科学分野:
- 免疫学 免疫学とは
- 移植生物学 移植生物学について
- 心血管研究 循環器科の研究
背景:
- 脳死は,ドナー心臓の炎症媒介体を調節する.
- これは心臓移植を受けた患者の急性拒絶を引き起こし,増幅する可能性があります.
- この研究では,ドナーの脳死が心臓アロ移植に与える影響を調査しています.
研究 の 目的:
- 心臓アロ移植におけるドナーの脳死による炎症性および免疫学的影響を調査する.
- 脳死ドナーからの心臓の拒絶率を,生きたドナーと比較するために.
主な方法:
- 心臓アロ移植は,脳死ラット (フィッシャー,F344) と生きたドナーのコントロールから,ルイス受容体に移植された.
- 脳死後に6時間の呼吸器支援を受けた後に心臓が移植されました.
- 炎症反応,サイトカイン/ケモカイン発現,白血球の浸透,MHCクラスII抗原のアップレギュレーションを評価した.
主要な成果:
- 脳死ドナーの心臓は,生きているドナーの心臓 (11.6日) よりもかなり早く (9.3日) 拒絶されました.
- 脳死は,炎症媒介体の急速な発現と白血球の浸透を含む炎症反応を加速しました.
- メジャーヒストコンパティビリティIIクラス抗原発現の増加 臓器免疫性向上.
結論:
- ドナーの脳死は,移植された心臓に有害です.
- 脳死による炎症因子の上昇は,宿主の免疫反応を誘発する.
- これは,改変されていない移植受容者の急性拒絶プロセスを加速します.
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