受体血清“封闭”供肝预防异种肝移植超急性排斥反应  

Recipient blood serum in the prevention of hyperacute rejection of liver xenotransplantation

作　　者：祝葆华[1] 童传明[1] 郭伟韬[1] 李明意[1] 张国平[1] 王兰天[1] 

机构地区：[1]广东医学院第一临床学院外科教研室,广东省湛江524023

出　　处：《中华普通外科杂志》2011年第10期817-819,共3页Chinese Journal of General Surgery

基　　金：基金项目：广东省自然科学基金资助项目（06301453）

摘　　要：目的探讨受体血清“封闭”供肝对异种肝移植超急性排斥反应（hyperacuterejection，HAR）的预防作用。方法取豚鼠和sD大鼠各20只，分别作为供体和受体，供受体随机配对；移植前采集受体大鼠近交系其他个体血清，45℃水浴灭活补体备用；实验组（n=10）术前用0．1％受体血清（recipientserum，RS）的Ringer液“封闭”供肝，对照组（n=10）仅用Ringer液灌洗供肝；采用改良“双套管法”行豚鼠、sD大鼠原位肝移植，观察供肝植人后形态学改变、受体存活时间、术后1h存活率，HE染色法检测移植肝微血栓、出血和肝细胞水肿等病理损害积分；检测血清丙氨酸转氨酶（ALT）评价肝功能。结果两组大鼠供体异种肝移植时间和无肝期比较，差异无统计学意义（P〉0．05）；对照组受体大鼠供肝充盈缓慢，灌注不均，实验组供肝充盈迅速，灌注较均匀；实验组受体大鼠术后存活时间和术后1h存活率较对照组均明显增加（P〈0．01），移植肝微血栓、间质出血（积分）较对照组明显减轻（P〈0．01），肝细胞水肿无明显差异（P〉0．05）；血清丙氨酸转氨酶（ALT）较对照组明显下降（P〈0．05）。结论受体血清“封闭”供肝对异种肝移植HAR具有一定的抑制作用，是预防器官移植HAR的潜在方法之一。Objective To investigate a new way to prevent hyperacute rejection （HAR） during liver xenotransplantation through blocking the xenograft with recipient blood serum before transplantation. Methods Twenty guinea-pig （GP） and Sprague-Dawley （SD） rats were pair-matched as donor and recipient randomly. Before transplantation, blood serum collected from other SD rats was inactivated at 45 ~C in water bath for 30 minutes. Guinea-pig donor livers from experimental group （ n = 10 ） were pre-perfused by 0. 1% solution of this blood serum, and donor livers from control group （n = 10） were treated by Ringer solution. Then orthotopic liver xenotransplantations were performed by the modified two-cuff technique immediately. Liver morphology changes and survival rate and time of recipients were observed, and histopathological lesions were detected by HE staining, and liver ALT level was evaluated. Results The operation time and anhepatie phases between two groups were not different significantly （ P 〉 0.05 ）. The survival rate of recipients from experimental group was higher, and its survival time was longer than that of control group significantly （ P 〈 0. 01 ）. The liver histological changes such as thrombosis and interstitial bleeding in experimental group was less severe than that in control group （ P 〈 0. 01 ）. The level of ALT in blood serum of rats from experimental group were lower than that from control group significantly （P 〈 O. 05）. Conclusions The results suggested that blocking the donor graft with recipient blood serum inhibits HAR during liver xenotransplantation.

关 键 词：肝移植 移植物排斥 受体血清 封闭 

分 类 号：R657.3[医药卫生—外科学]