临床小肠移植排斥反应的防治

PREVENTION AND TREATMENT OF CLINICAL SMALL BOWEL ALLOGRAFT REJEC-TION

采用环孢素Ａ、雷公藤多甙、甲基氢化泼尼松、前列腺素Ｅ１伍用的新型免疫抑制方案，预防小肠移植排斥反应取得满意效果。病人存活３ｌ０ｄ。经验表明，通过内窥镜和肠粘膜组织病理检查，监测排斥反应简便实用有效。利用聚合酶链反应（ＰＣＲ）技术研究发现，移植术后供肠细胞向受体组织移居嵌合（ｃｈｉｍｅｒｉｓｍ），而临床无法植物抗宿主病（ＧＶＨＤ）发生。促进细胞移居嵌合可能有利于防止排斥反应的发生。

The major problem in small bowel transplantation is rejection. Satisfatory result was achieved in preventing small bowel allograft rejection by combined use of cyclosporin A,tripterygium wolfordii,methylpred- nisolone and prostaglandin E1.All the patients treated survived for 310 days. It is an easy,practical and effective method to monitor graft-rejection by endoscopic and histopathological examination of mucosa of small intestine. By PCR technique,cell migration and cygochimera were found in receptor tissues,but no graft versus host reac- tion occurred.It is suggested that cell migration and cytochimera may be helpful in preventing graft-rejection.