Fischlein T, Schütz A, Haushofer M, Frey R, Uhlig A, Detter C, Reichart B
Department of Cardiac Surgery, University of Munich-Grosshadern Medical Center, Germany.
Ann Thorac Surg. 1995 Aug;60(2 Suppl):S122-5; discussion S125-6. doi: 10.1016/0003-4975(95)00257-l.
Homograft cell viability after cryopreservation was investigated and cytoimmunologic monitoring was performed during the early postoperative course to research possible immunologic reactions after allograft aortic valve replacement. After cryopreservation, morphologic observations were made, a nonradioactive cell proliferation assay was used, and prostaglandin I2 secretion of the remaining endothelial cells was determined. Cytoimmunologic monitoring was performed daily within the first 3 weeks postoperatively. An increase of the activation index greater than 1 was rated as an immunologic reaction. Maintained metabolic activity of graft endothelial cells after cryopreservation was confirmed by prostaglandin I2 release (9.24 +/- 3.48 ng/cm2 basic release and 20.1 +/- 5.76 ng/cm2 when stimulated with 25 mumol/L Na arachidonic acid). Cell proliferation was indicated after graft incubation with the nonradioactive viability kit (0.27 +/- 0.9 at 450 nm). Cytoimmunologic examinations (n = 861) after homograft implantation showed a more intense activation in patients with ABO-incompatible grafts (activation index 2.1 +/- 1.6, n = 16) than in those with ABO-compatible grafts (activation index 1.3 +/- 0.8, n = 17). In these groups, the duration of activation by cytoimmunologic monitoring was 2.8 +/- 1.5 days and 1.3 +/- 0.6 days, respectively (p < 0.041). No activation was observed in 8 patients after xenograft valve replacement (p < 0.01). Our data indicate that cryopreservation of homograft valves represents a cell- and tissue-protective preservation method. Postoperatively, all homograft valves caused immunologic reactions, which were reversible without immunosuppression treatment.
研究了同种异体移植物冷冻保存后的细胞活力，并在术后早期进行了细胞免疫监测，以研究同种异体主动脉瓣置换术后可能的免疫反应。冷冻保存后，进行形态学观察，使用非放射性细胞增殖测定法，并测定剩余内皮细胞的前列腺素I2分泌。术后前3周每天进行细胞免疫监测。活化指数增加大于1被评定为免疫反应。通过前列腺素I2释放证实了冷冻保存后移植物内皮细胞的代谢活性得以维持（基础释放为9.24±3.48 ng/cm2，用25 μmol/L花生四烯酸钠刺激时为20.1±5.76 ng/cm2）。用非放射性活力试剂盒培养移植物后显示有细胞增殖（450 nm处为0.27±0.9）。同种异体移植物植入后的细胞免疫检查（n = 861）显示，ABO血型不相容移植物患者（活化指数2.1±1.6，n = 16）的活化比ABO血型相容移植物患者（活化指数1.3±0.8，n = 17）更强烈。在这些组中，细胞免疫监测的活化持续时间分别为2.8±1.5天和1.3±0.6天（p < 0.041）。异种移植物瓣膜置换术后8例患者未观察到活化（p < 0.01）。我们的数据表明，同种异体瓣膜的冷冻保存是一种细胞和组织保护保存方法。术后，所有同种异体瓣膜均引起免疫反应，在无免疫抑制治疗的情况下这些反应是可逆的。
