Moriyama H, Sasajima T, Hirata S, Yamazaki K, Yatsuyanagi E, Kubo Y
First Department of Surgery, Asahikawa Medical College, Japan.
Ann Thorac Surg. 2000 Jun;69(6):1701-6. doi: 10.1016/s0003-4975(00)01297-2.
We examined the blood supply of a cryopreserved tracheal allograft and its morphohistologic changes after transplantation.
In each of 22 dogs, a five-ring tracheal segment was replaced by one of the following tracheal grafts: fresh autografts (n = 8), cryopreserved tracheal allografts (n = 8), or fresh allografts (n = 6). The cryopreserved tracheal allografts were preserved at -196 degrees C for 60 days. No immunosuppressant was given to any of the animals. All grafts were retrieved at 1 and 12 weeks and assessed by microangiography and histology.
The epithelial denudation and the revascularization of the transverse intercartilaginous arteries were recognized within 7 days as common to each of the three types of grafts. In the cryopreserved tracheal allografts, neither cartilage degradation nor graft shrinkage occurred at 7 days. However, the recanalized transverse intercartilaginous arteries completely disappeared at 12 weeks, and marked shrinkage occurred; the cartilage cells were accompanied by karyolysis and were significantly decreased in number (p < 0.05). Recanalization of the transverse intercartilaginous arteries was also demonstrated in the fresh allografts; however, necrosis abruptly occurred as a result of acute rejection responses.
Cryopreservation of a tracheal allograft provided sufficient reduction of the acute rejection responses, and blood supply to the cryopreserved tracheal allograft was established through the recanalized transverse intercartilaginous arteries within 7 days; however, subsequent chronic rejection responses resulted in occlusion of the transverse intercartilaginous arteries and atrophy.
我们研究了冷冻保存的气管同种异体移植物的血液供应及其移植后的形态组织学变化。
在22只犬中,每只犬的一个五环气管段被以下气管移植物之一替代:新鲜自体移植物(n = 8)、冷冻保存的气管同种异体移植物(n = 8)或新鲜同种异体移植物(n = 6)。冷冻保存的气管同种异体移植物在-196℃下保存60天。所有动物均未给予免疫抑制剂。所有移植物在1周和12周时取出,通过微血管造影和组织学进行评估。
在7天内,三种类型的移植物均出现上皮剥脱和横向软骨间动脉的血管再生。在冷冻保存的气管同种异体移植物中,7天时既未发生软骨降解也未发生移植物收缩。然而,再通的横向软骨间动脉在12周时完全消失,并出现明显收缩;软骨细胞伴有核溶解,数量显著减少(p < 0.05)。新鲜同种异体移植物中也证实了横向软骨间动脉的再通;然而,由于急性排斥反应,坏死突然发生。
气管同种异体移植物的冷冻保存充分降低了急性排斥反应,冷冻保存的气管同种异体移植物在7天内通过再通的横向软骨间动脉建立了血液供应;然而,随后的慢性排斥反应导致横向软骨间动脉闭塞和萎缩。