移植小肠病理学诊断标准及其进展  

Diagnostic criteria and its progress on intestinal graft pathology

作　　者：郭晖[1] 陈知水[1] Guo Hui;Chen Zhishui(Institute of Organ Transplantation,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Key Laboratory of Organ Transplantation of Ministry of Education,Key Laboratory of Organ Transplantation of National Health Commission of China,Key Laboratory of Organ Transplantation of Chinese Academy of Medical Sciences,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院器官移植研究所,器官移植教育部重点实验室国家卫生健康委员会器官移植重点实验室,中国医学科学院器官移植重点实验室,武汉430030

出　　处：《器官移植》2022年第3期307-316,共10页Organ Transplantation

基　　金：中国医学科学院中央级公益性科研院所基本科研业务费专项资金资助(2019PT320014)。

摘　　要：小肠移植已经成为肠衰竭最为理想的治疗方式。现代临床小肠移植包括3种类型:单独小肠移植、肝小肠联合移植和腹腔多器官簇移植。移植小肠具有与其它实体移植器官显著不同的免疫学和解剖生理学特点,导致移植小肠出现显著的急性排斥反应、慢性排斥反应、移植物抗宿主病(GVHD)、感染和移植后淋巴组织增生性疾病(PTLD)等诸多独特且严重的并发症,其中以急性排斥反应和感染尤为棘手。通过对移植小肠的内窥镜观察及肠黏膜活组织检查可以对上述并发症及时予以诊断和鉴别,进而予以针对性的治疗,更好地保障移植受者和移植小肠的长期存活。Intestinal transplantation has become the most ideal treatment for intestinal failure.Modern clinical intestinal transplantation includes three types:isolated intestinal transplantation,combined liver-intestinal transplantation and abdominal multivisceral transplantation.The immunological,anatomical and physiological characteristics of intestinal grafts significantly differ from those of other solid transplant organs.Consequently,intestinal grafts could develop specific and severe complications,such as acute rejection,chronic rejection,graft-versus-host disease(GVHD),infection and posttransplant lymphoproliferative disease(PTLD),among which acute rejection and infection are extremely challenging.Endoscopic examination and intestinal mucosal biopsy of intestinal grafts could be performed to make timely diagnosis and differentiation of these complications,then deliver targeted treatment and guarantee the long-term survival of recipients and intestinal grafts.

关 键 词：单独小肠移植 肝小肠联合移植 腹腔多器官簇移植 排斥反应 移植物抗宿主病(GVHD) 移植后淋巴组织增生性疾病(PTLD) 内窥镜检查 活组织检查 

分 类 号：R617[医药卫生—外科学] R574.5[医药卫生—临床医学]