Gurakar A, Fagiuoli S, Hassanein T, Wright H I, Balkan M, Frezza E, Todo S, Starzl T E, Van Thiel D H
Pittsburgh Transplantation Institute, University of Pittsburgh Medical Center, PA 15213.
Surg Endosc. 1994 Jul;8(7):762-4. doi: 10.1007/BF00593436.
Utilization of endoscopy to both visualize and selectively biopsy an intestinal allograft has become the standard for early recognition and treatment of intestinal allograft rejection. Despite the widespread acceptance of the need for selective mucosal biopsies, it has not been shown that the histological features of intestinal allograft rejection are either localized or occur as part of a more diffuse phenomenon within a tubular allograft. To resolve these issues, 88 ileoscopies were performed in 12 small-bowel allograft recipients and mucosal biopsy samples were obtained at 5, 10, and 15 cm, respectively, from the ileal stoma. Each mucosal biopsy was labeled, processed, and evaluated individually for the presence and severity of any evidence for allograft rejection. The data obtained suggest that intestinal allograft rejection is a diffuse process, and biopsies obtained randomly from an ileal graft are likely to demonstrate evidence of allograft rejection when such is present.
利用内镜对肠道移植进行可视化和选择性活检已成为早期识别和治疗肠道移植排斥反应的标准。尽管选择性黏膜活检的必要性已被广泛接受，但尚未证实肠道移植排斥反应的组织学特征是局限的，还是作为管状移植体内更弥漫性现象的一部分出现。为解决这些问题，对12例小肠移植受者进行了88次回肠镜检查，并分别从回肠造口处5厘米、10厘米和15厘米处获取黏膜活检样本。对每个黏膜活检样本进行标记、处理，并单独评估是否存在移植排斥反应的证据及其严重程度。所获得的数据表明，肠道移植排斥反应是一个弥漫性过程，当存在移植排斥反应时，从回肠移植随机获取的活检样本很可能显示出移植排斥反应的证据。
