Dupuy J M, Gilmore N, Goldman H, Tsoukas C, Pekovic D, Chausseau J P, Duperval R, Joly M, Pelletier L, Thibaudeau Y
Immunology Research Center, Institut Armand Frappier, Quebec University, Montreal, Canada.
Thymus. 1991 Jun;17(4):205-18.
From October 1983 to July 1984, 11 adult AIDS patients have received single or repeated thymic grafts. All have had opportunistic infections and 3 also had Kaposi's sarcoma. Thymic tissue from infants undergoing cardiac surgery was cultured to provide a thymocyte- and fibroblast-free epithelial cell inoculum. 18-21 days post-explantation, cells and explants were injected intraperitoneally, intramuscularly or intrahepatically. Transplants were well tolerated in all cases. In 7 cases liver biopsy was performed at the time of grafting and 2 months later. Ten patients have died after a mean survival time following transplantation of 8.7 months while 1 patient was lost to follow up. Clinical improvement and absence of new opportunistic infections were apparent for 4 months following transplantation. Partial immunoreconstitution was evidenced by an increase in peripheral blood lymphocytes (8 of 10 cases) and lymphocyte subsets (7 of 10 cases) as well as by presence of T4 and T8 positive cells in the liver (5 of 7 cases). In 5 of 7 patients, double-staining immunofluorescence showed that HIV-I antigens were present in T4-phenotype cells, at the site of the graft, 2 months after grafting, but were not detected in the liver at the time of grafting. Transient immunoreconstitution, therefore, maybe related to destruction of newly differentiated T lymphocytes.
1983年10月至1984年7月，11例成年艾滋病患者接受了单次或重复胸腺移植。所有患者均有机会性感染，3例还患有卡波西肉瘤。对接受心脏手术的婴儿的胸腺组织进行培养，以提供无胸腺细胞和成纤维细胞的上皮细胞接种物。移植后18 - 21天，将细胞和外植体通过腹腔内、肌肉内或肝内注射。所有病例对移植的耐受性良好。7例患者在移植时及2个月后进行了肝活检。10例患者在移植后的平均生存时间为8.7个月后死亡，1例患者失访。移植后4个月临床症状改善，且无新的机会性感染。外周血淋巴细胞（10例中的8例）和淋巴细胞亚群（10例中的7例）增加，以及肝脏中存在T4和T8阳性细胞（7例中的5例）证明了部分免疫重建。在7例患者中的5例中，双重免疫荧光染色显示，移植后2个月，HIV - I抗原存在于移植部位的T4表型细胞中，但在移植时肝脏中未检测到。因此，短暂的免疫重建可能与新分化的T淋巴细胞的破坏有关。
