Cooper D K, Human P A, Lexer G, Rose A G, Rees J, Keraan M, Du Toit E
Department of Cardiothoracic Surgery, University of Cape Town Medical School, South Africa.
J Heart Transplant. 1988 May-Jun;7(3):238-46.
The problem of donor heart supply would be solved if hearts could be transplanted from readily available animals such as the pig or sheep. We have investigated heterotopic heart transplantation (in the neck) with the pig as donor and baboon as recipient. Five experimental groups were studied. Control hearts (group 1, n = 4) were rejected within 4 minutes to 8 hours. Splenectomy done before transplantation (group 2, n = 3) did not extend survival significantly (30 minutes to 8 hours). Donor heart survival in baboons receiving immunosuppressive therapy of cyclosporine and methylprednisolone (group 3, n = 5) was from 15 to 75 minutes only in four animals and for 5 days in one animal. Anti-pig antibody adsorption from baboon blood by pretransplant donor-specific kidney hemoperfusion (group 4, n = 7) resulted in cardiac function for 6 to 12 hours in three cases and from 4 to 5 days in four cases (p less than 0.02). A combination of pretransplant antibody adsorption and immunosuppression (group 5, n = 4) resulted in graft survival of 8 to 20 hours in three cases and of 4 days in one case (p less than 0.03). Histopathologic features of vascular (hyperacute) rejection were seen in all hearts except one (the 5-day survivor in group 3). Pretransplant adsorption of antibody clearly prolonged survival of discordant cardiac xenografts in some cases. Further exploration of this technique appears justified.
如果能够使用猪或羊等易于获取的动物心脏进行移植，供体心脏供应问题便可得到解决。我们研究了以猪为供体、狒狒为受体的异位心脏移植（颈部移植）。共研究了五个实验组。对照组心脏（第1组，n = 4）在4分钟至8小时内被排斥。移植前进行脾切除术（第2组，n = 3）并未显著延长存活时间（30分钟至8小时）。接受环孢素和甲基强的松龙免疫抑制治疗的狒狒（第3组，n = 5）中，仅4只动物的供体心脏存活时间为15至75分钟，1只动物的存活时间为5天。移植前通过供体特异性肾脏血液灌注吸附狒狒血液中的抗猪抗体（第4组，n = 7），3例心脏功能维持了6至12小时，4例维持了4至5天（p < 0.02）。移植前抗体吸附与免疫抑制相结合（第5组，n = 4），3例移植物存活时间为8至20小时，1例为4天（p < 0.03）。除1例（第3组中存活5天的动物）外，所有心脏均出现了血管（超急性）排斥的组织病理学特征。移植前抗体吸附在某些情况下明显延长了异种心脏移植物的存活时间。进一步探索这项技术似乎是合理的。
