Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY.
Transplantation Biology Research Center Laboratory, Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Boston, MA.
Am J Transplant. 2017 Jul;17(7):1778-1790. doi: 10.1111/ajt.14210. Epub 2017 Mar 3.
In our studies of life-supporting α-1,3-galactocyltransferase knockout (GalT-KO) pig-to-baboon kidneys, we found that some recipients developed increased serum creatinine with growth of the grafts, without histological or immunological evidence of rejection. We hypothesized that the rapid growth of orthotopic pig grafts in smaller baboon recipients may have led to deterioration of organ function. To test this hypothesis for both kidneys and lungs, we assessed whether the growth of outbred (Yorkshire) organ transplants in miniature swine was regulated by intrinsic (graft) or extrinsic (host environment) factors. Yorkshire kidneys exhibited persistent growth in miniature swine, reaching 3.7 times their initial volume over 3 mo versus 1.2 times for miniature swine kidneys over the same time period. Similar rapid early growth of lung allografts was observed and, in this case, led to organ dysfunction. For xenograft kidneys, a review of our results suggests that there is a threshold for kidney graft volume of 25 cm /kg of recipient body weight at which cortical ischemia is induced in transplanted GalT-KO kidneys in baboons. These results suggest that intrinsic factors are responsible, at least in part, for growth of donor organs and that this property should be taken into consideration for growth-curve-mismatched transplants, especially for life-supporting organs transplanted into a limited recipient space.
在我们对支持生命的α-1,3-半乳糖基转移酶敲除(GalT-KO)猪-狒狒肾脏的研究中,我们发现一些受者在移植物生长的同时血清肌酐升高,而没有排斥反应的组织学或免疫学证据。我们假设,在较小的狒狒受者中,原位猪移植物的快速生长可能导致器官功能恶化。为了对肾脏和肺部进行这一假设的检验,我们评估了杂种(约克夏)器官移植在小型猪中的生长是否受到内在(移植物)或外在(宿主环境)因素的调节。约克夏肾脏在小型猪中持续生长,在 3 个月内达到初始体积的 3.7 倍,而同期小型猪肾脏的生长速度为 1.2 倍。观察到同种异体肺移植物的早期快速生长,在这种情况下,导致器官功能障碍。对于异种肾移植,我们对结果的回顾表明,在狒狒中,受者体重 25 cm/kg 的移植物体积阈值会导致 GalT-KO 肾脏发生皮质缺血。这些结果表明,内在因素至少部分负责供体器官的生长,在进行生长曲线不匹配的移植时,尤其是在有限的受者空间中移植支持生命的器官时,应该考虑到这一特性。