Suga H, Ishida H, Kimikawa M, Hayasaka Y, Teraoka S, Agishi T, Ota K
3rd Department of Surgery, Tokyo Women's Medical College, Japan.
ASAIO Trans. 1991 Jul-Sep;37(3):M433-4.
A double filtration plasmapheresis (DFPP) technique was applied to selectively remove the natural antibodies in discordant xenotransplantation. A swine heart was heterotopically transplanted in a canine neck after two DFPP procedures during which 200 to 500 ml of plasma were replaced with the same amount of Hartman's solution containing 7% human albumin. Mean removal rate of IgC and IgM by DFPP ranged from 74.2 +/- 0.5 to 95.9 +/- 2.8%. The anti-swine lymphocytotoxic reaction of canine serum was decreased after DFPP but still remained in low titers. Mean graft survival time in the group treated by DFPP in which 1000 ml of plasma was totally replaced was prolonged to 107 +/- 47 min, while it was 9 +/- 5 min in the group without any treatment (p less than 0.01). Deposits of canine IgM and C3 on the vascular endothelium of the graft were observed on immunofluorescence, while there were no deposits of IgG. In conclusion, DFPP effectively removed the natural antibodies, resulting in prolongation of xenograft survival time. Immunofluorescence study suggested that natural IgM antibodies played an important role in this xeno-hyperacute rejection.
采用双重过滤血浆置换（DFPP）技术选择性去除非协调性异种移植中的天然抗体。在进行两次DFPP操作后，将猪心脏异位移植到犬颈部，在此过程中用等量含7%人白蛋白的哈特曼溶液替代200至500毫升血浆。DFPP对IgC和IgM的平均清除率在74.2±0.5%至95.9±2.8%之间。DFPP后犬血清的抗猪淋巴细胞毒性反应降低，但仍维持在低滴度。在血浆完全置换1000毫升的DFPP治疗组中，移植物平均存活时间延长至107±47分钟，而未进行任何治疗的组为9±5分钟（p<0.01）。免疫荧光观察到犬IgM和C3在移植物血管内皮上的沉积，而未观察到IgG的沉积。总之，DFPP有效去除了天然抗体，从而延长了异种移植物的存活时间。免疫荧光研究表明天然IgM抗体在这种异种超急性排斥反应中起重要作用。
