[心脏临床同种异体移植术后心肌的体液免疫病理变化]

[Humoral immunopathologic changes in the myocardium after clinical allotransplantation of the heart].

作者信息

Beletskaia L V, Baranova F S, Khalimova Z A, Kurenkova L G, Kazakov E N, Kormer A I, Chestukhin V V, Za'idenov V a, Boikina T V, Selezneva E A

机构信息

Research Institute of Transplantology and Artificial Organs, Moscow, Russia.

出版信息

Arkh Patol. 1995 Nov-Dec;57(6):3-7.

PMID:8742178

Abstract

Endomyocardial diagnostic biopsies, recipient heart removed at operation, endomyocardial biopsies of allotransplants and postmortem material were studied using immunofluorescence to specify immunopathological process and to detect humoral rejection. Altogether 306 samples from 55 patients were studied. In the early postoperative period (one year) 8 out of 18 patients with heart transplants repeatedly showed immunopathologic picture of acute humoral (vascular) rejection which was characterized by a widespread immunoglobulin G and complement fixation in the capillary walls accompanied by enhanced capillary permeability and fibrin deposition in intestitial tissue. Such patients often had graft dysfunction. 1 to 5 years after transplantation in 24 out of 37 patients discrete focal immunoglobulin and complement fixation was observed as one of chronic rejection component.

摘要

采用免疫荧光法对心内膜诊断性活检、手术切除的受体心脏、同种异体移植的心内膜活检及尸检材料进行研究，以明确免疫病理过程并检测体液性排斥反应。共研究了55例患者的306份样本。在术后早期（1年），18例心脏移植患者中有8例反复出现急性体液（血管）排斥反应的免疫病理表现，其特征为毛细血管壁广泛存在免疫球蛋白G和补体沉积，伴有毛细血管通透性增强和间质组织纤维蛋白沉积。这类患者常出现移植物功能障碍。移植后1至5年，37例患者中有24例出现散在局灶性免疫球蛋白和补体沉积，这是慢性排斥反应的组成部分之一。