Randolph M A, Yaremchuk M J, Moore J R, Robinson R A, Weiland A J
Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Microsurgery. 1987;8(4):210-7. doi: 10.1002/micr.1920080409.
Presented here is a compendium of studies investigating the fate of vascularized bone allografts. The first set of experiments employ the posterior rib graft in two canine models. The rib-to-mandible model was used to evaluate the rejection phenomena of vascularized bone allografts in an outbred dog model. This ascertained the time course of rejection and histological characteristics of the grafts. Immunosuppression of the graft recipients was attempted with azathioprine and cyclosporine. The results demonstrated that azathioprine was not an effective immunosuppressant, whereas cyclosporine resulted in survival of cortical osteons. The use of the vascularized rib allograft, with and without azathioprine, to bridge the defect in the dog femur was met with failure. Further studies employed a genetically defined rat model to determine the effect of different histocompatibilities on the survival of vascularized knee allografts. Grafts were transplanted from Lewis rats to syngeneic Lewis rats as isografts and to Fischer-344 rats (F-344) and Brown-Norway rats (BN) as allografts. Grafts across a major histocompatibility barrier to BN were rejected by 7 days, whereas grafts across a weak histocompatibility barrier to F-344 were rejected more slowly. The use of cyclosporine in this model abrogated the rejection response when administered to both groups continuously. However, a short course of cyclosporine was effective in preventing rejection in the F-344 animals. Efforts to induce tolerance by blood transfusions, from the donor strain or from a third-party donor, were not effective in preventing rejection.
本文介绍了一系列关于带血管骨移植命运的研究综述。第一组实验在两种犬类模型中使用了后肋骨移植。肋骨-下颌骨模型用于评估杂种犬模型中带血管骨移植的排斥现象。这确定了排斥的时间进程以及移植物的组织学特征。尝试用硫唑嘌呤和环孢素对移植物接受者进行免疫抑制。结果表明，硫唑嘌呤不是一种有效的免疫抑制剂，而环孢素可使皮质骨单位存活。使用带血管的肋骨移植体（无论是否使用硫唑嘌呤）来修复犬股骨缺损均告失败。进一步的研究采用了基因明确的大鼠模型，以确定不同组织相容性对带血管膝关节移植存活的影响。移植物从Lewis大鼠移植到同基因的Lewis大鼠作为同基因移植，移植到Fischer-344大鼠（F-344）和Brown-Norway大鼠（BN）作为异基因移植。跨越主要组织相容性屏障到BN的移植物在7天内被排斥，而跨越较弱组织相容性屏障到F-344的移植物被排斥得较慢。在该模型中，当对两组持续给予环孢素时，可消除排斥反应。然而，短疗程的环孢素在预防F-344动物的排斥反应方面是有效的。通过输注供体品系或第三方供体的血液来诱导耐受的努力，在预防排斥反应方面并不有效。
