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目的探讨大鼠同种异体序贯复合组织移植(SCTA)对先前实质器官移植免疫效应的影响。方法取WKY大鼠左肺原位移植到F344大鼠,应用Cuff技术分别吻合左肺动脉、左肺静脉及主支气管。术后对F344大鼠应用环孢素(CsA)5 mg/kg隔日皮下注射,共10 d;以呼吸频率检测移植左肺功能。肺移植后第11天,取Brown Norway大鼠腹部3 cm×3 cm肌皮瓣原位移植至F344大鼠,皮瓣吻合血管为股动脉和股静脉,皮瓣移植后停止应用免疫抑制剂。同种异体复合组织移植(CTA)10 d后,取移植皮瓣和肺组织行组织病理学检查,观察排斥反应。结果大鼠肺移植手术成功率90%,CTA手术成功率100%,SCTA成功率90%。移植肺的呼吸频率从移植10 d后(应用免疫抑制剂10 d)的(61±10)次/min增加到移植20 d后(停用免疫抑制剂10 d)的(75±15)次/min。移植肺显示出典型的急性免疫排斥反应,包括血管周围及肺组织内弥漫的淋巴细胞浸润。自体移植腹壁皮瓣病理组织学检查未发现免疫排斥反应,CTA术后皮瓣显示典型血管周围及皮瓣内弥漫的淋巴细胞浸润。结论 SCTA大鼠模型的建立对于实质器官移植后CTA及二次移植免疫抑制方案的研究具有重要意义。
Objective To investigate the effect of rat allogenic sequential tissue transplantation (SCTA) on the immune response of previous organ transplantation. Methods The left lungs of WKY rats were transplanted into F344 rats in situ and the left pulmonary artery, left pulmonary vein and main bronchus were respectively anastomosed with Cuff technique. Postoperative F344 rats were injected subcutaneously with cyclosporin (CsA) 5 mg / kg every other day for 10 days. Left lung function was measured by respiratory rate. On the 11th day after lung transplantation, 3 cm × 3 cm myocutaneous flap of Brown Norway rats were transplanted in situ to F344 rats. The anastomosed blood vessels of the flaps were femoral artery and femoral vein. The immunosuppressive agents were stopped after the flap was transplanted. After 10 days of allogeneic composite tissue transplantation (CTA), the skin flap and lung tissue were taken for histopathological examination to observe the rejection. Results The success rate of lung transplantation in rats was 90%, the success rate of CTA was 100%, and the success rate of SCTA was 90%. The respiratory rate of transplant lung increased from (61 ± 10) times / min after 10 days of transplantation (application of immunosuppressive agents for 10 days) to (75 ± 15) times / min after transplantation for 20 days (10 days after immunosuppressive agents were stopped) min. Transplanted lung showed a typical acute immune rejection, including perivascular and pulmonary tissue diffuse lymphocytic infiltration. Autologous transplantation of abdominal wall flap histological examination found no immune rejection, CTA flap showed typical perivascular and perforation of the flaps within the lymphocyte infiltration. Conclusion The establishment of SCTA rat model is of great significance for the study of CTA and immunosuppressive regimens after secondary transplantation.