Division of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland.
J Heart Lung Transplant. 2012 Jan;31(1):94-100. doi: 10.1016/j.healun.2011.10.003.
Acute rejection (AR) episodes after lung transplantation (Tx) are orchestrated by cells of the innate and adaptive immune system targeting the engrafted organ. The assessment and classification of pathologic changes of AR relies essentially on conventional histology. Herein we apply the technique of scanning electron microscopy (SEM) to identify and characterize ultrastructural changes of the pulmonary graft after lung Tx.
Orthotopic single-lung Tx was performed between BALB/c (donor) and C57BL/6 (recipient) mice. At Day 5 after Tx, lung allografts were recovered for SEM and for histologic analysis.
Upon Tx, high numbers of leukocytes and thrombocytes were found, showing an activated surface pattern and a change of their cell body shape. These cells adhered and partly transmigrated through the endothelium of vessels. Larger vessels were more affected than smaller vessels and the endothelium was roughened in its surface texture throughout. As a phenomenon, airways were partly covered by activated dendritic cells. Numerous thrombocytes and macrophages accumulated on the endothelium of the cuff anastomosis region exposing this area to a particularly higher risk of thrombosis.
SEM allows for detection of morphologic changes during pulmonary allograft rejection and adds important data to conventional histology when making the diagnosis of acute rejection.
肺移植（Tx）后急性排斥（AR）发作是由靶向移植物的固有和适应性免疫系统的细胞协调的。AR 的病理改变的评估和分类主要依赖于常规组织学。在此，我们应用扫描电子显微镜（SEM）技术来识别和描述肺 Tx 后肺移植物的超微结构变化。
在 BALB/c（供体）和 C57BL/6（受体）小鼠之间进行原位单肺 Tx。Tx 后第 5 天，回收肺同种异体移植物进行 SEM 和组织学分析。
Tx 后，发现大量白细胞和血小板，表现出激活的表面模式和细胞体形状的变化。这些细胞黏附和部分穿过血管的内皮细胞迁移。较大的血管比小血管更容易受到影响，整个内皮表面纹理变得粗糙。作为一种现象，气道部分被激活的树突状细胞覆盖。大量血小板和巨噬细胞在内皮袖口吻合区域积聚，使该区域特别容易发生血栓形成。
SEM 允许在肺同种异体移植排斥期间检测形态变化，并在进行急性排斥诊断时为常规组织学提供重要数据。
