大鼠肝小肠联合移植的研究

An experimental study on combined small bowel/liver transplantation in rats

采用封闭群大鼠建立一种肝小肠联合移植模型,研究肝移植后的自然耐受状态对小肠移植物的保护作用。结果发现:在封闭群单独小肠移植组大鼠,术后14天内排斥率为100%。与之相比。肝小肠联合移植组大鼠术后14天时小肠排斥率显著降低(55.6%,P<0.01),小肠排斥的程度也比单独同品种小肠移植组轻。该组另有44.4%的大鼠至术后14天时移植小肠无排斥,肠壁上Ach E,AkP和ATP_()等酶的活性以及SP,VIP能神经元成分也有明显恢复。证实肝对小肠具有保护作用,它诱导产生耐受,使小肠移植避免或推迟发生排斥。

A model of combined small bowel/liver transplantation were established in the closed colony SD or Wistar rat to investigate whether simultaneous liver transplantation is capable of protecting the small bowel from rejection. Three types of transplants were studied: isolated liver transplantation (LT, SD—SD, n=9), isolated small bowel transplantation (SBT, which included SD-to-SD group(n=13) and SD-to-Wistar group (n=8), combined small bowel/liver graft (LS BT, SD-SD, n=9). No immunosuppressant was given and all rats were observed until death or sacrificing on 14th postoperative day (POD14). The grafts in recipients were examined histologically and immunohistochemically. The results showed that the rejection rate of grafted liver within 14 day was 50% in LT rats, and that of grafted intestine was 100% in SBT rats(in both SD-to-SD or SD-to-Wistar group). However, the POD14 rejection rate of grafted intestine was significantly lower in LSBT rats(55.6%) than in SBT rats(P<0.001). The other rats(44.4%) of LSBT had a normal histological appearance when examined on POD14, and the enzymes activity (ATP, AKP, AchE and MAO) and nerve components(SP and VIP) in the grafted intestine recovered to some degree. It is concluded that liver could induce immune tolerance, protect intestine from rejection or delay the rejection in combined small bowel/liver transplantation.