Knechtle S J, Halperin E C, Murphy C E, Saad T, Abernethy K, Miller D, Bollinger R R
J Heart Transplant. 1985 Sep-Oct;4(5):541-5.
Transplantation into sensitized recipients is contraindicated due to the potential for hyperacute rejection. In order to study the mechanism of hyperacute rejection and the role of immunosuppression in the face of presensitization, we evaluated the effect of total lymphoid irradiation, cyclosporine, and cobra venom factor, alone and in combination, on hyperacute rejection of heterotopic rat heart allografts. Lewis rats were sensitized to strongly RT-1-incompatible ACI rats by three successive skin grafts. Heart allografts were then performed, and survived for a mean period of 15.7 +/- 7.4 hours. Neither preoperative treatment of hypersensitized rats with total lymphoid irradiation alone nor with cyclosporine (5 mg/kg/day) resulted in a prolongation of survival (20.4 +/- 16.6 hours and 35.6 +/- 6.2 hours, respectively). However, complement depletion using cobra venom factor significantly prolonged mean graft survival time to 114.4 +/- 31.0 hours (p less than 0.05). Cyclosporine (10 mg/kg/day) also significantly prolonged survival to 149 +/- 29 hours (p less than 0.01), but did not lower the antibody or complement levels. The addition of total lymphoid irradiation or cyclosporine to treatment with cobra venom factor did not result in longer survival than cobra venom factor alone. In conclusion, cobra venom factor and cyclosporine delay but do not prevent hyperacute rejection, while total lymphoid irradiation has no observable effect on hyperacute rejection.
由于存在超急性排斥反应的可能性，因此禁忌将移植物移植到致敏受体中。为了研究超急性排斥反应的机制以及免疫抑制在预致敏情况下的作用，我们评估了全身淋巴照射、环孢素和眼镜蛇毒因子单独或联合使用对异位大鼠心脏同种异体移植物超急性排斥反应的影响。通过连续三次皮肤移植使Lewis大鼠对强RT-1不相容的ACI大鼠致敏。然后进行心脏同种异体移植，移植物平均存活15.7±7.4小时。对致敏大鼠术前单独使用全身淋巴照射或使用环孢素（5毫克/千克/天）治疗均未延长存活时间（分别为20.4±16.6小时和35.6±6.2小时）。然而，使用眼镜蛇毒因子消耗补体可显著延长移植物平均存活时间至114.4±31.0小时（p<0.05）。环孢素（10毫克/千克/天）也显著延长存活时间至149±29小时（p<0.01），但未降低抗体或补体水平。在使用眼镜蛇毒因子治疗的基础上添加全身淋巴照射或环孢素，其存活时间并不比单独使用眼镜蛇毒因子更长。总之，眼镜蛇毒因子和环孢素可延迟但不能预防超急性排斥反应，而全身淋巴照射对超急性排斥反应无明显影响。
