猪肢体移植模型建立的临床病理研究

目的　在大型动物 (猪 )上建立同种异体肢体移植模型 ,探讨同种异体肢体移植中肉眼观察与组织学之间的关系 ,以及皮肤排斥反应的机理。方法　对 9只不同窝的实验猪进行异体前肢移植 ,其中 3例为未用药组 ,6例为用药组。分别在术后不同时间对移植体的皮肤进行了肉眼观察及 72次活检病理组织学检查 ,并采用S -P免疫组化法进行CD3、CD4、CD8检测。结果　术后皮肤均在不同时期发生了不同程度的排斥反应。未用药组发生了严重排斥反应 ,移植肢体在 1周内坏死。用药组在免疫抑制剂的作用下 ,移植肢体获得了长期存活。对皮肤的肉眼观察和组织学检查 ,在确定早期的排斥反应。皮肤的排斥反应中CD3均有不同程度表达(10 0 % ) ;CD4及CD8表达分别为 (2 3 6 1% )及 (9 72 % ) ,后二者主要表达在发生严重排斥反应的病例中。结论　同种异体肢体移植在免疫抑制剂的作用下可获得长期存活。肉眼观察可以观察早期的排斥反应 ,病理组织学检查是诊断排斥反应的可靠依据。皮肤的排斥反应可能主要为一种T细胞介导的细胞免疫反应 ,T淋巴细胞亚群的监测有助于判断移植肢体的存活和诊断排斥反应的发生

Clinical and pathologic study in swine limb allograft.

Objective The animal model of forelimb allognaft were created in order to study the relationship between macroscopic and histological findings and the mechanisms of skin rejection in tnansplanted limb.Method The forelimb allografts were performed in 9 pigs from different family;these pigs included drug used group(6 pigs)and non drug used group(3 pigs).The macroscopic observation and histopathological examination of allotransplanted limb's skin were done, the preoperative skin as control.S P immunohistological method was used to assay CD3,CD4 and CD8.Result Different degree rejection was found in all skin.Severe rejection was found in skin in non drug used group and allografed limbs died in one week after transplantation.Allografted limbs in drug-used group survived for a long time because of the action of immunosuppressive drugs.Macroscopic observation and histological examination could early define rejection.CD3 expressed in all skin rejection(100%);CD4 express level was 22.22% and CD8 was 9.72%,they mainly expressed in those cases that severe rejection had been found.Conclusion Allografted limbs can survive for a long time on the action of immunosuppressive drugs.Macroscopic observation of skin is an effective method to define the early rejection,histopathological examination is reliable for diagnosing rejection.Skin rejection maybe a T cell mediated cellular immunity,monitoring of T lymphocyte subgroup helps for judging of survival of transplanted limbs and diagnosing of rejection.