Kawahara K, Hiratsuka M, Mikami K, Makihata S, Yoneda S, Shiraishi T, Okabayashi K, Shirakusa T
Second Department of Surgery, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
Jpn J Thorac Cardiovasc Surg. 2001 Jan;49(1):53-7. doi: 10.1007/BF02913124.
Obliterative airway disease occurring in concordant tracheal xenografts in rodent models is histologically similar to obliterative bronchiolitis in human lung allografts. We studied whether obliterative airway disease would occur in a large animal-discordant model.
Pig and dog tracheas were cryopreserved for 7 to 14 days, and 18 recipient dogs given splenectomy 7 days before transplantation, then seven tracheal rings were removed and a corresponding five-ring donor tracheal segment was transplanted to the excised site. Grafts were wrapped with pedicled omentum and inmmunosuppression was conducted with tacrolimus or deoxyspergualin. Graft status was observed by bronchoscopy. Dogs were classified into three groups. Group 1 consisted of dog-to-dog allotransplantation animals (control group, n = 5), Group 2 of pig-to-dog xenotransplantation animals (n = 8), and Group 3 of pig-dog xenotransplantation animals who also underwent graft stenting immediately after transplantation (n = 5).
Grafts healed well in 4 of 5 Group 1 dogs. Tracheal stricture began on day 5 post transplantation and the lumen was obstructed by fibrosis by days 8 to 14 in all Group 2 dogs. All Group 3 dogs remained in good respiratory status until death.
Obliterative airway disease developed quickly in pig-to-dog discordant tracheal xenografts. Graft stenting is a feasible treatment for managing of tracheal obstruction.
啮齿动物模型中，在协调性气管异种移植中出现的闭塞性气道疾病在组织学上与人类肺同种异体移植中的闭塞性细支气管炎相似。我们研究了在大型动物非协调性模型中是否会发生闭塞性气道疾病。
将猪和狗的气管冷冻保存7至14天，18只受体狗在移植前7天进行脾切除术，然后切除七个气管环，并将相应的五环供体气管段移植到切除部位。用带蒂大网膜包裹移植物，并用他克莫司或去氧精胍菌素进行免疫抑制。通过支气管镜观察移植物状态。将狗分为三组。第1组由犬到犬同种异体移植动物组成（对照组，n = 5），第2组由猪到犬异种移植动物组成（n = 8），第3组由移植后立即进行移植物支架置入的猪 - 犬异种移植动物组成（n = 5）。
第1组5只狗中有4只移植物愈合良好。第2组所有狗在移植后第5天开始出现气管狭窄，到第8至14天管腔被纤维化阻塞。第3组所有狗直至死亡呼吸状态良好。
猪到犬非协调性气管异种移植中闭塞性气道疾病发展迅速。移植物支架置入是治疗气管阻塞的一种可行方法。
