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在小肠移植中取代捐赠者的淋巴组织
Y Iwaki1, T E Starzl, A Yagihashi
1Department of Surgery, University of Pittsburgh School of Medicine, Pennsylvania.
Lancet (London, England)
|April 6, 1991
概括
在小肠移植中,最初出现的是供体淋巴细胞,但被清除,受体细胞重新填充了移植. 这挑战了传统的拒绝假设,并表明需要新的预防策略.
科学领域:
- 移植免疫学 移植免疫学
- 胃肠病学 胃肠病学
- 手术方面的创新.
背景情况:
- 接收者淋巴细胞在移植中传统上与排斥有关.
- 了解肠道移植后的淋巴细胞动态对于移植的存活至关重要.
研究的目的:
- 为了调查小肠移植后的捐赠者和接受者的淋巴细胞的命运.
- 重新评估淋巴细胞在肠道移植排斥中的作用.
主要方法:
- 进行了三次小肠移植 (两次肝脏移植).
- 患者接受了FK 506免疫抑制剂.
- 通过使用HLA类型的外周血液和移植活检监测了捐赠细胞的存在.
主要成果:
- 在移植后早期的接受者血液中 (5-11%) 检测到捐赠者淋巴细胞,但在12-54天内消失.
- 移植活检显示,在10-12周的时间里,捐赠者淋巴细胞在自身膜中逐渐被接受者淋巴细胞取代.
- 肠上皮细胞仍然来源于供体;患者通过肠道食表现出良好的康复.
结论:
- 供体淋巴细胞的存在并不一定等同于肠道移植的排斥.
- 接收者淋巴细胞重新填充移植的关键特征.
- 目前用于预防肠道移植排斥的策略可能需要重新评估.
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