供犬脾灌注对特异性致敏犬移植肾功能的影响  

Immune protective effect of donor spleen perfusion on the renal allografts in specific sensitized canine recipients

作　　者：谢森[1] 唐礼功[1] 刘幼英[1] 成俊[2] 夏穗生[2] 

机构地区：[1]广州军区武汉总医院泌尿外科,430070 [2]华中科技大学同济医学院附属同济医院器官移植研究所

出　　处：《中华器官移植杂志》2007年第12期737-740,共4页Chinese Journal of Organ Transplantation

摘　　要：目的探讨供犬脾灌注对特异性致敏犬移植肾的免疫保护作用。方法雄性家犬作为肾移植的供、受者。首先采用供者淋巴细胞多次输注诱导18只受者致敏后,随机平均将致敏受者分为3组。特异性脾灌注组:用加工过的人用血液透析穿刺管将同一供者的离体脾动、静脉与受者的腹主动脉及下腔静脉连通后开放血流(血流量约18～25 ml/min),充盈后轻揉脾脏,灌注40min,然后用同一供肾行肾移植术;非特异性脾灌注组:离体脾灌注以及肾移植的方法与特异性脾灌注组相同,不同的是供脾和供肾均来自于无关供者;对照组:开腹旷置40min后,同法行肾移植。监测脾灌注前、后各组受者微量淋巴细胞毒(CDC)试验和混合淋巴细胞培养(MLC)的变化;观察供者脾灌注对受者移植肾排斥反应发生和肾功能的影响。结果各组受者均在输注淋巴细胞3～4次后诱导致敏成功。特异性脾灌注可以显著降低受者CDC配型水平和MLC淋巴细胞增殖水平,使受者外周血白细胞计数一过性减少,总补体溶血活性(CH_(50))下降。肾移植术后特异性脾灌注组移植肾肾小球滤过率下降较非特异性脾灌注组和对照组缓慢;病理检查提示术后特异性脾灌注组移植肾排斥反应较非特异性脾灌注组和对照组为轻。结论供者脾灌注可以特异性吸附毒性抗体,使外周血激活淋巴细胞归巢,耗竭血小板,从而延缓特异性致敏受者肾移植后排斥反应的发生,改善移植肾功能。Objective To assess the immune protective effect of donor spleen perfusion on the renal allografts in specific sensitized canine recipients. Methods Male dogs were operated as donors and recipients for kidney transplantation- Eighteen dogs were previously sensitized by a method of multiinfusion of small number of lymphocytes from a paired donor and were then randomly divided into 3 groups equally. In donor specific spleen perfusion group, the artery and vein of the excised donor canine spleen were connected to the abdominal aortic artery and inferior vena cava of the recipient with processed fistula tubes, perfused at a speed of 18-25 ml/min for 40 min and then kidney from the same donor was transplanted to the recipient; In non-specific spleen perfusion group, the methods of excised spleen perfusion and kidney transplantation were indifferent to the above group except for the organs which removed from a non-specific donor; In control group, kidney transplantations were performed after an exclusion time of 40 min in the open abdominal surgery. Cross-match between paired dogs monitored by means of complement dependent cytotoxicity （CDC） and mixed lymphocyte culture （MLC） test before and after donor spleen perfusion was investigated. Rejection episodes and serum creatinine level in each group were assessed after kidney transplantation. Results Immune sensitization was successfully induced in all 3 groups after 3 to 4 times of donor lymphocyte stimulations. CDC as well as lymphocytes proliferation in MLC and CH50 of recipients was significantly declined after specific spleen perfusion, and white blood cell count in peripheral blood also decreased transiently. After kidney transplantation between the paired sensitized dogs, the advanced rate of renal allograft function deterioration was slower in specific spleen perfusion group than in other two groups. The pathologic investigation suggested that severity of rejection in spleen perfusion group was milder than in other two groups. Conclusions Donor spleen perf

关 键 词：肾移植 致敏 犬 脾 灌注 

分 类 号：R699.2[医药卫生—泌尿科学]