de Bruin R W, Heineman E, Meijssen M A, Jeekel H, Marquet R L
Department of General Surgery, and Paediatric Surgery, Erasmus University, Rotterdam, The Netherlands.
Transplantation. 1990 Dec;50(6):928-30.
The effects of pretransplant donor-specific blood transfusion on the survival of orthotopic small bowel transplants in rats were investigated in the fully allogeneic BN (Rt1n) to WAG (Rt1u) donor-host combination. Previous studies show that in this combination DSTs lead to permanent survival of heterotopically transplanted hearts, marked prolongation of kidney grafts, and moderate prolongation of pancreas grafts but have no effect on skin grafts. Without pretreatment, total small bowel grafts (+/- 45 cm) were rejected in 12.2 +/- 1.8 days (mean +/- SD), and 10-cm segments of jejunum or ileum in 11.2 +/- 4.0 and 11.6 +/- 0.5 days, respectively. Three DSTs given on days -21, -14, and -7 before transplantation had no effect on graft survival in any of the groups tested. Total small bowel grafts were rejected in 12.8 +/- 2.5 days, and 10-cm-long segments or jejunum or ileum in 17.0 +/- 7.2 days and 11.5 +/- 2.7 days, respectively. Graft-versus-host disease, which was mild and transient, occurred in 50% of the nontreated rats engrafted with a total small bowel, in 40% of the animals transplanted with an ileum segment, and in none of the rats that received a jejunal transplant. In the DST-pretreated groups, none of the animals transplanted with a total small bowel or ileum segment and 16.6% of the animals transplanted with a jejunum segment showed clinical signs of GVHD. When DST pretreatment was combined with cyclosporine, grafts did not survive any longer than with cyclosporine treatment alone. It is concluded that DSTs ameliorate GVHD but do not prolong the survival of small bowel allografts nor act additively with cyclosporine treatment.
在完全同种异体的BN（Rt1n）到WAG（Rt1u）供体 - 宿主组合中，研究了移植前供体特异性输血对大鼠原位小肠移植存活的影响。先前的研究表明，在这种组合中，供体特异性输血可导致异位移植心脏的永久存活、肾移植的显著延长以及胰腺移植的适度延长，但对皮肤移植没有影响。未经预处理时，全小肠移植（±45 cm）在12.2±1.8天（平均值±标准差）被排斥，空肠或回肠的10 cm节段分别在11.2±4.0天和11.6±0.5天被排斥。在移植前第 - 21、- 14和 - 7天给予三次供体特异性输血对任何测试组的移植物存活均无影响。全小肠移植在12.8±2.5天被排斥，10 cm长的空肠或回肠节段分别在17.0±7.2天和11.5±2.7天被排斥。移植物抗宿主病轻微且短暂，在接受全小肠移植的未治疗大鼠中有50%发生，在接受回肠节段移植的动物中有40%发生，而接受空肠移植的大鼠中无一发生。在供体特异性输血预处理组中，接受全小肠或回肠节段移植的动物均未出现移植物抗宿主病的临床症状，接受空肠节段移植的动物中有16.6%出现该症状。当供体特异性输血预处理与环孢素联合使用时，移植物存活时间并不比单独使用环孢素治疗时长。结论是，供体特异性输血可改善移植物抗宿主病，但不能延长小肠同种异体移植物的存活时间，也不能与环孢素治疗产生相加作用。
