辐照同种异体血管移植的实验研究

Experimental Study of Irradiated Allograft Blood Vessel

目的探讨在不用免疫抑制的条件下,开展同种异体血管移植的可行性。方法(1)在无菌条件及无创伤原则下切取Wistar大鼠股动脉,-10℃^-20℃保存或真空包装常温保存,16 kGy 60Coγ射线照射。(2)分辐照同种异体血管移植组、新鲜同种异体血管移植组和新鲜自体血管移植组进行血管移植。于移植后1周、2周、1个月、2个月、3个月5个时间点观察移植血管的通畅率,并取材作组织学检测。结果:(1)辐照处理的同种异体动脉无任何组织学结构改变,肉眼观察外形无明显变化。(2)辐照同种异体血管移植组、新鲜同种异体血管移植组和新鲜自体血管移植组移植血管的通畅率分别为90%(27/30)、30%(9/30)和93.3%(28/30)。辐照同种异体血管移植组和新鲜自体血管移植组移植后2周移植血管内膜出现内皮细胞,移植后3个月移植血管内膜内皮细胞覆盖完整。新鲜同种异体血管移植组移植早期有淋巴细胞及炎性细胞浸润,有明显血管结构破坏出现,移植血管内膜未见内皮细胞覆盖。结论辐照同种异体血管完全符合理想的血管移植物所具备的条件;在不使用任何免疫抑制的条件下,应用辐照同种异体血管进行同种异体血管移植是可行的。

Objective To research the potential usage without immune-supressing treatment. Methods （1） Wistar rat＇s femur arteries were taken carefully under sterilized condition and were freezed at temperature from - 10℃～ - 20℃ freezed stored in vacuum condition and then exposed to irradiation of ^60Coγ rays at a dose of 16 kGy. （2）The experimental rats were divided into the irradiated allograft, Fresh allograft and Fresh autograft group. Samples were taken after one week, two weeks, one month, two months and three months, and the patent rates and histologic changes were observed. Results （1） After HE staining, there was no histologic change of the irradiated allograft arteries observed and no obvious changes were observed by visual sight. （2） The patent rates for the irradiated allograft, fresh allograft and fresh autograft group were 90% （27/30）, 30% （9/30） and 93. 3 % （28/30） respectively. The endothelial cells appeared in the inner surface of the irradiated allograft and fresh autograft two weeks after surgery and three months later the inner surface were fully covered by endothelial cells. As for fresh allograft, there were lymphcytes and inflammatory cells infiltration in stage early, the structures were damaged, no endothelial cells appeared on the inner surface. Conclusions Irradiated allograft blood vessels in every aspects fit for ideal requirements of prosthesis. It is possible to adopt irradiated allograft without using immune-supressing treatments.