Yowell R L, Hammond E H, Bristow M R, Watson F S, Renlund D G, O'Connell J B
Department of Pathology, University of Utah Medical School, Salt Lake City 84143.
J Heart Transplant. 1988 May-Jun;7(3):191-7.
A case of acute vascular rejection occurring in a cardiac allograft is presented. The rejection was characterized by prominent lymphocytic infiltration of the major coronary arteries in a pattern similar to that observed in acute vascular rejection occurring in renal allografts. Additionally, there was electron microscopic evidence of endothelial damage of smaller vessels. In addition to routine light microscopic evaluation of heart biopsies obtained in this case, immunofluorescent staining of biopsies for IgG, IgM, C3, Clq, fibrinogen, T cells, B cells, and Ia human leukocyte antigen (HLA-DR) was also performed. These studies suggest that antibodies may have been important in the terminal rejection episode described in this case. Furthermore, immunofluorescent staining detected continuing endothelial cell damage, reflected as Ia antigen positivity of allograft blood vessels, despite apparent improvement of rejection as judged by light microscopy.
本文报道了一例心脏同种异体移植中发生的急性血管排斥反应。该排斥反应的特征是主要冠状动脉有明显的淋巴细胞浸润，其模式与肾同种异体移植中发生的急性血管排斥反应相似。此外，电镜证据显示小血管存在内皮损伤。除了对该病例获取的心脏活检组织进行常规光学显微镜评估外，还对活检组织进行了IgG、IgM、C3、Clq、纤维蛋白原、T细胞、B细胞和Ia人类白细胞抗原（HLA-DR）的免疫荧光染色。这些研究表明，抗体可能在该病例所描述的终末期排斥反应中起重要作用。此外，免疫荧光染色检测到尽管光学显微镜判断排斥反应明显改善，但同种异体移植血管的Ia抗原阳性反映出内皮细胞持续损伤。
