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Diagnosis and treatment of acute rejection in the first case of human living-related small bowel transplantation with a long-term survival in China.中国首例长期存活的亲属活体小肠移植急性排斥反应的诊断与治疗
World J Gastroenterol. 2005 Sep 14;11(34):5332-5. doi: 10.3748/wjg.v11.i34.5332.
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[Monitoring of interleukin-8 in urine and in serum of patients after kidney transplantation].[肾移植术后患者尿液和血清中白细胞介素-8的监测]
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Rejection of cardiac allografts by T cells expressing a restricted repertoire of T-cell receptor V beta genes.表达受限T细胞受体Vβ基因库的T细胞对心脏同种异体移植物的排斥反应。
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中国首例长期存活的亲属活体小肠移植急性排斥反应的诊断与治疗

Diagnosis and treatment of acute rejection in the first case of human living-related small bowel transplantation with a long-term survival in China.

作者信息

Song Wei-Liang, Wang Wei-Zhong, Wu Guo-Sheng, Li Meng-Bin, Li Ji-Peng, Ji Gang, Dond Guang-Long, Zhang Hong-Wei

机构信息

Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China.

出版信息

World J Gastroenterol. 2005 Sep 14;11(34):5332-5. doi: 10.3748/wjg.v11.i34.5332.

DOI:10.3748/wjg.v11.i34.5332
PMID:16149141
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4622804/
Abstract

AIM

To report the comprehensive diagnosis and treatment of acute rejection in the first case of living-related small bowel transplantation with a long-term survival in China.

METHODS

A 18-year-old boy with short gut syndrome underwent living-related small bowel transplantation, with the graft taken from his father (44-year old). A segment of 150-cm distal small bowel was resected from the donor. The ileo-colic artery and vein from the donor were anastomosed to the infrarenal aorta and vena cava of the recipient respectively. The intestinal continuity was restored with an end-to-end anastomosis between the recipient jejunum and donor ileum, and the distal end was fistulized. FK506, MMF and prednisone were initially used for post-transplant immunosuppression. Endoscopic observation and mucosal biopsies of the graft were carried out through the terminal ileum enterostomy; serum was collected to detect the levels of IL-2R, IL-4, IL-6 and IL-8. The change of the graft secretion and absorption was observed.

RESULTS

Acute rejection was diagnosed promptly and cured. The patient was in good health, 5 years after living-related small bowel transplantation.

CONCLUSION

The correct diagnosis and treatment of acute rejection are the key to the long-term survival after living-related small bowel transplantation.

摘要

目的

报道我国首例亲属活体小肠移植长期存活病例急性排斥反应的综合诊治情况。

方法

一名18岁短肠综合征男孩接受亲属活体小肠移植，供体为其父亲（44岁）。从供体切除一段150厘米的远端小肠。供体的回结肠动静脉分别与受体的肾下腹主动脉和腔静脉吻合。通过受体空肠与供体回肠端端吻合恢复肠道连续性，远端造瘘。术后初始使用FK506、霉酚酸酯和泼尼松进行免疫抑制。通过末端回肠造口术对移植物进行内镜观察和黏膜活检；采集血清检测IL-2R、IL-4、IL-6和IL-8水平。观察移植物分泌和吸收情况的变化。

结果

急性排斥反应得到及时诊断并治愈。亲属活体小肠移植5年后患者健康状况良好。

结论

急性排斥反应的正确诊断和治疗是亲属活体小肠移植长期存活的关键。