Trento A, Hardesty R L, Griffith B P, Zerbe T, Kormos R L, Bahnson H T
University of Pittsburgh, Department of Surgery, PA 15261.
J Thorac Cardiovasc Surg. 1988 Jan;95(1):37-41.
Traditionally, the human lymphocyte antigens have been considered to be the major barrier to successful transplantation, and lymphocytes have been used as the target cell in evaluating histocompatibility. The presence in the serum of recipients of preformed antibodies, cytotoxic to donors lymphocytes, is associated with a high probability of hyperacute rejection. We identified 11 patients in whom, despite a compatible direct lymphocytotoxic cross-match, acute failure of the cardiac homograft was associated with histologic and immunologic findings consistent with hyperacute rejection. Direct immunofluorescence and immunohistochemical staining showed the presence of antibodies on the surface of vascular endothelial cells in each of these 11 patients. The serum of these recipients was found to contain antibodies against a panel of endothelial cells. In contrast, cytotoxic antibodies to vascular endothelial cells were not present in a control group of 18 heart transplant recipients who did not experience hyperacute rejection. Thus the presence of antibodies against vascular endothelial cells seems to be related to hyperacute rejection of the cardiac allograft.
传统上，人类淋巴细胞抗原一直被认为是成功移植的主要障碍，淋巴细胞也一直被用作评估组织相容性的靶细胞。受者血清中存在对供者淋巴细胞具有细胞毒性的预先形成的抗体，与超急性排斥反应的高概率相关。我们鉴定出11例患者，尽管直接淋巴细胞毒性交叉配型相容，但心脏同种异体移植的急性衰竭却与符合超急性排斥反应的组织学和免疫学发现相关。直接免疫荧光和免疫组织化学染色显示，这11例患者中的每一例血管内皮细胞表面均存在抗体。发现这些受者的血清中含有针对一组内皮细胞的抗体。相比之下，在未发生超急性排斥反应的18例心脏移植受者的对照组中，不存在针对血管内皮细胞的细胞毒性抗体。因此，针对血管内皮细胞的抗体的存在似乎与心脏同种异体移植的超急性排斥反应有关。
