Kuusanmäki P, Halttunen J, Paavonen T, Pakarinen M, Luukkonen P, Häyry P
Second Department of Surgery, Helsinki University Central Hospital, Finland.
Transplantation. 1994 Oct 15;58(7):757-63.
Using nonimmunosuppressed piglet small bowel grafts, we performed a detailed histological study on acute rejection and analyzed altogether 45 different histological parameters throughout the bowel wall, in 10 allografts and 6 autografts. Heterotopic grafts were followed by full-thickness biopsies every other day beginning on the 3rd day after transplantation. The parameters were scored from 0 to 3 according to the severity of the change and the values of every variable were compared statistically between the 2 groups. The earliest significant changes, beginning on days 3-5, were infiltration of inflammatory cells and pyroninophilia among these cells in lamina propria; edema, fibrosis, and inflammation in submucosa and muscularis; vacuolar degeneration of myocytes; and endothelial and intimal changes in vessels. Villous blunting and cuboidal epithelium were the other early markers. On day 7, the epithelial and vascular changes became most significant. We want to emphasize especially the vascular parameters: endothelial swelling and proliferation, intimal thickening, intramural inflammation, and obliteration of the lumen. The dilatation of lymph vessels and changes of Peyer's patches had no value in the estimation of rejection. All allografts became necrotic by day 11 after transplantation.
我们使用未免疫抑制的仔猪小肠移植物，对急性排斥反应进行了详细的组织学研究，并在10例同种异体移植物和6例自体移植物中，分析了整个肠壁的45个不同组织学参数。从移植后第3天开始，每隔一天对异位移植物进行全层活检。根据变化的严重程度，将参数从0到3进行评分，并对两组之间每个变量的值进行统计学比较。最早的显著变化始于第3 - 5天，表现为固有层中炎症细胞浸润以及这些细胞中的嗜派洛宁现象；黏膜下层和肌层出现水肿、纤维化和炎症；肌细胞空泡变性；血管内皮和内膜变化。绒毛变钝和立方上皮是其他早期标志。在第7天，上皮和血管变化最为显著。我们尤其想强调血管参数：内皮肿胀和增殖、内膜增厚、壁内炎症以及管腔闭塞。淋巴管扩张和派伊尔结的变化在排斥反应评估中无价值。所有同种异体移植物在移植后第11天均发生坏死。
