同种异体小肠移植的实验研究和临床应用

Experimental and clinical studies of small bowel allo-transplantation

作者报告了同种异体小肠移植的动物实验结果和国内首例应用情况。以猪为模型，分为无免疫抑制（Ⅰ）组，大剂量环孢素（ＣｓＡ）（Ⅱ）组，小剂量ＣｓＡ（Ⅲ）组，雷公藤加小剂量ＣｓＡ（Ⅳ）组，存活１００天后单用雷公藤（Ⅴ）组。术后Ⅰ、Ⅲ组均发生急性排斥；Ⅱ、Ⅳ组未发生急性排斥，但Ⅱ组中有２只猪因严重感染而死亡；Ⅴ组中继续服用雷公藤的动物长期存活。一例３１岁女性患者因慢性小肠结肠炎、反复肠梗阻、短肠综合征而接受全小肠移植。移植肠热缺血６分钟，冷缺血９小时４５分钟。免疫抑制方案为ＣｓＡ、雷公藤、甲基强地松龙联合用药。迄今术后已２５７天，移植肠功能正常。

AbstractThe pigs with allograft were divided into 5 groupsaccording to the different immunosuppressive regi-mens,Acute rejection of allograft occurred in animalsnot treated with immunosuppressive agents or treatedwith low dose of cyclosporine(CsA ).There was norejection developed in the pigs treated with high doseCsA or low dose CsA and tripterygium wolfordii(TW).No evidence of chronic rejection was detectedin animals with continued administration of TW afterliving longer than 100 days when the immunosup-pressive treatment was discontinued.Awoman withenterocolitis , ileus and short-gut syndrome received acomplete cadaveric small bowel transplantation inmarch 12, 1994.The graft had minutes for warm is-Chcmia and 9 hours and 45 minutes for cold ischemia.The immunosuppressive therapy consisted of CsA,TW and methylprednisolone,The patient is alive andthe function of graft is normal.