同种异体肢体(手)移植  

A clnical report of limb allograft

作　　者：张信英[1] 于钟毓[1] 毕郑钢[1] 张震宇[1] 尚剑[1] 邵明[1] 张军[1] 曹阳[1] 杨成林[1] 杜劲松[1] 

机构地区：[1]哈尔滨医科大学第一临床医学院骨科,黑龙江哈尔滨150001

出　　处：《哈尔滨医科大学学报》2004年第5期461-464,F003,共5页Journal of Harbin Medical University

基　　金：黑龙江省"九五"攻关课题资助项目 (G97C18 4 3 )

摘　　要：目的　通过 3例 (5个肢体 )移植探讨同种异体肢体 (手 )移植后 ,手部功能恢复的可能性。方法　根据ABO血型、Rh血型 ,人体白细胞抗原 (HLA) ,群体反应性抗体 (PRA)的检测和淋巴细胞毒性交叉试验等 ,选择临床死亡者作供体。移植的平面分别为双腕上 5cm ,肘关节和双前臂中上 1 3处。移植的具体方法类似于自体断肢再植 ,术前、术中、术后联合应用免疫抑制剂。结果　 3例 (5个肢体 )术后经过顺利 ,未发生排斥反应现象 ,移植的 5只手血循环正常 ,生命体征平稳。移植的 5只手功能恢复较满意。结论　在联合应用免疫抑制剂的情况下 ,同种异体肢体 (手 )移植能够存活 ,手部的功能可以恢复。Objective To evaluate the feasibility of the limb allograft and the reconstruction of the limb function after 3 case of alograft (5 limbs).Methods Brain-dead donors were chosen under the test of blood type in ABO and Rh,HLA,PRA and the mixed leukocyte culture.The level of the transplanted limbs were at 5cm above the wrist,elbow and 1/3 distal to elbow seperately.The procedure of the allotransplantation was similar to that of the autologous replantation.The immunosuppressants were taken two days before the operation,in the operation and after the operation.Results The progress was satisfactory.No rejection was found after operation.The circulation of allografts was normal and the vital signs were stable.The function of allotransplanted hands recovered well.Conclusion With the immunosuppressive agents,the allografts can survive and the function recover.

关 键 词：异体移植 肢体 组织配型 排斥反应 功能恢复 

分 类 号：R658.1[医药卫生—外科学]