小型猪肺脏同种异体移植及术后监测

Allogeneic lung transplantation in miniature pigs and postoperative monitoring

  • 摘要:
    目的  探讨小型猪同种异体肺移植及术后监测在肺移植研究中的可行性与参考价值。
    方法  2例小型猪(R1和R2)行左肺同种异体移植,术前进行补体依赖细胞毒性试验及血液交叉配型,术中记录主要操作时间和开放肺动脉后动脉血氧分压(PaO2),术后检测血常规、血液生化指标及炎症因子,并行多器官病理学检查。
    结果  补体依赖细胞毒性试验结果显示供受体淋巴细胞存活率42.5%~47.3%,交叉配血均无发生凝集反应。D1、D2热缺血时间分别为17 min、10 min,冷缺血时间分别为246 min、216 min,最终R1、R2分别存活1.5 h和104 h。R1术后白蛋白(ALB)、球蛋白(GLB)均下降,丙氨酸转氨酶升高;R2术后ALB、GLB、天冬氨酸转氨酶均升高;2例受体尿素氮、血清肌酐均升高。病理结果显示R1移植肺部分实变伴炎症细胞浸润,多器官充血及损伤;R2移植肺严重坏死伴纤维增生,多器官轻中度损伤。移植肺白细胞介素-1β、白细胞介素-6表达水平均有所升高。
    结论  小型猪同种异体肺移植模型可系统评估免疫学相容与否、术中功能及术后器官损伤,所得数据可为后续肺移植研究提供技术参考。

     

    Abstract:
    Objective  To explore the feasibility and reference value of allogeneic lung transplantation and postoperative monitoring in miniature pigs for lung transplantation research.
    Methods  Two miniature pigs (R1 and R2) underwent left lung allogeneic transplantation. Complement-dependent cytotoxicity tests and blood cross-matching were performed before surgery. The main operative times and partial pressure of arterial oxygen (PaO2) after opening the pulmonary artery were recorded during surgery. Postoperatively, routine blood tests, biochemical blood indicators and inflammatory factors were detected, and pathological examinations of multiple organs were conducted.
    Results  The complement-dependent cytotoxicity test showed that the survival rate of lymphocytes between donors and recipients was 42.5%-47.3%, and no agglutination reaction occurred in the cross-matching. The first warm ischemia times of D1 and D2 were 17 min and 10 min, respectively, and the cold ischemia times were 246 min and 216 min, respectively. Ultimately, R1 and R2 survived for 1.5 h and 104 h, respectively. Postoperatively, in R1, albumin (ALB) and globulin (GLB) decreased, and alanine aminotransferase increased; in R2, ALB, GLB and aspartate aminotransferase all increased. Urea nitrogen and serum creatinine increased in both recipients. Pathological results showed that in R1, the transplanted lung had partial consolidation with inflammatory cell infiltration, and multiple organs were congested and damaged. In R2, the transplanted lung had severe necrosis with fibrosis, and multiple organs had mild to moderate damage. The expression levels of interleukin-1β and interleukin-6 increased in the transplanted lungs.
    Conclusions  The allogeneic lung transplantation model in miniature pigs may systematically evaluate immunological compatibility, intraoperative function and postoperative organ damage. The data obtained may provide technical references for subsequent lung transplantation research.

     

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