大鼠肾移植术后成分输血的疗效与意义

The influence of leukocyte-deleted transfusion on rats after renal transplantation

目的探讨肾移植术后输注去白细胞成分血对受体的影响。方法以健康封闭群Wistar大鼠为供体,SD大鼠为受体,建立大鼠肾移植模型。将成模大鼠随机分为3组,每组10只。A组为对照组,肾移植术后不给予特殊处理;B组于移植术后输注近交系DA大鼠去白细胞成分血;C组在成分输血的基础上每日给予糖皮质激素(3mg/kg)治疗。分别于术前和术后第4日应用流式细胞仪检测各组受体外周血T淋巴细胞亚群变化情况。结果术后第4日所有受体均健康存活,B组CD4+/CD8+T细胞值较A组明显升高,差异有统计学意义(P(0.05),C组与B组比较,CD4+/CD8+T细胞值明显降低,差异有统计学意义(P(0.01)。结论由于去白细胞成分血仍存在少量白细胞,且红细胞自身具有免疫原性,移植术后可能会激活受体免疫系统,诱发排斥反应,但大量免疫抑制剂的应用可帮助抑制去白细胞成分血可能导致的排斥反应。

Objective To investigate the influence of leukocyte-deleted transfusion on rats after renal transplantation. Methods Healthy closed population Wistar rats were used as donors and SD rats as recipients. The Wistar to SD model of renal allograft rejection was developed. All the 30 recipients were randomly divided into 3 groups, group A was regarded as control group which received no special treatment after renal transplantation, group B was transfused leukocyte-deleted blood from inbred line DA rat after operation without any other treatment,group C was given steroid 3 mg/（ kg·d） since operation. T lymphocyte subgroup was tested before transplantation and on the 4th day after operation by flow cytometry. Results On the 4th day after transplantation, all the recipients healthy lived. The ratio of CD4^ ＋/CD8^ ＋T cell in group B was higher than that of group A, the difference between them was significant. The ratio of CD4^＋/CD8^＋ T cell in group C decreased obviously compared with group B, there was a significant difference between them. Conclusion Immune system of recipients may be activated post transplantation by microamount leukocyte and erythrocyte in leukocyte-deleted blood just for its immunogenicity, which can even cause acute rejection. On the other hand, application of large amount immunosuppressant can decrease possibility of acute rejection caused by leukocyte-deleted blood.