Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Ann Surg. 2013 Mar;257(3):542-7. doi: 10.1097/SLA.0b013e31825c5349.
Generation of human livers in pigs might improve the serious shortage of grafts for human liver transplantation, and enable liver transplantation without the need for deceased or living donors. We developed a chimeric liver (CL) by repopulation of rat hepatocytes in a mouse and successfully transplanted it into a rat recipient with vessel reconstruction. This study was designed to investigate the feasibility of CL for supporting the recipient after auxiliary liver grafting.
Hepatocytes from luciferase transgenic or luciferase/LacZ double-transgenic rats were transplanted into 20- to 30-day-old urokinase-type plasminogen activator/severe-combined immunodeficiency (uPA/SCID) mice (n = 40) to create CLs with rat-origin hepatocytes. After replacement of mouse hepatocytes with those from rats, the CLs were transplanted into wild-type Lewis (n = 30) and analbuminemia (n = 10) rats, followed by immunosuppression using tacrolimus (TAC) with/without cyclophosphamide (CPA) or no immunosuppression. Organ viability was traced by in vivo bioimaging and Doppler ultrasonography in the recipient rats for 4 to 6 months. Rat albumin production was also evaluated in the analbuminemia rats for 4 months. In addition, histological analyses including Ki67 proliferation staining were performed in some recipients.
Both immunosuppressive protocols significantly improved graft survival and histological rejection of CLs as compared to the nonimmunosuppressed group. Although rat albumin production was maintained in the recipients for 4 months after transplantation, ultrasonography revealed patent circulation in the grafts for 6 months. Ki67 staining analysis also revealed the regenerative potential of CLs after a hepatectomy of the host native liver, whereas immune reactions still remained in the mouse-origin structures.
This is the first report showing that engineered CLs have potential as alternative grafts to replace the use of grafts from human donors.
在猪体内生成人类肝脏可能会改善人体肝移植中严重的供体短缺问题,使无需依赖已故或活体捐献者即可进行肝移植。我们通过将大鼠肝细胞再殖到小鼠体内,开发了嵌合肝(CL),并成功将其移植到接受血管重建的大鼠受体中。本研究旨在探讨 CL 在辅助性肝移植后支持受体的可行性。
将荧光素酶转基因或荧光素酶/LacZ 双转基因大鼠的肝细胞移植到尿激酶型纤溶酶原激活剂/严重联合免疫缺陷(uPA/SCID)小鼠(n=40)中,以创建具有大鼠来源肝细胞的 CL。在小鼠肝细胞被大鼠来源的肝细胞替代后,将 CL 移植到野生型 Lewis(n=30)和白蛋白血症(n=10)大鼠中,然后使用他克莫司(TAC)联合/不联合环磷酰胺(CPA)或不进行免疫抑制进行免疫抑制。在受体大鼠中通过体内生物成像和多普勒超声追踪 4 至 6 个月的器官存活情况。在白蛋白血症大鼠中还评估了 4 个月的大鼠白蛋白产生情况。此外,对一些受体进行了包括 Ki67 增殖染色在内的组织学分析。
与未免疫抑制组相比,两种免疫抑制方案均显著提高了 CL 的移植物存活率和组织学排斥反应。尽管大鼠白蛋白的产生在移植后 4 个月内仍能维持,但超声检查显示移植后 6 个月内移植物仍有通畅的循环。Ki67 染色分析还显示了宿主固有肝脏肝切除后 CL 的再生潜力,而免疫反应仍存在于小鼠来源的结构中。
这是第一个报道表明,工程化的 CL 具有作为替代移植物的潜力,可以替代来自人类供体的移植物。