同种异体气管移植的研究及展望

Research and prospect of tracheal allotransplantation

学术背景:同种异体气管移植是气管移植研究的热点,新观点、新进展不断涌现。目的:总结分析近年来气管移植的现状及进展,介绍气管移植研究的新方法、新观点。检索策略:作者应用计算机检索,以网络数据库资源为主,查询Science Direct,Pubmed,Springer等数据库1990-01/2007-07有关同种异体气管移植方面的文章,检索词为"tracheal,allotransplantation,allograft",并限定文章语言种类为English。同时应用计算机检索CNKI数据库1994-01/2007-07有关同种异体气管移植方面的文章,限定文章种类为中文,检索词"同种异体,气管,移植"。初检得到328篇文献,140篇符合纳入标准,取其中有关气管移植的30篇文献进行归纳总结。纳入标准:文章所述重点与气管移植相关。排除标准:重复性文章。文献评价:30篇文献中7个实验分析了移植气管的血运建立问题;17个实验分析了气管的免疫排斥问题;6个实验分析了移植气管组织细胞的再生与组织诱导因子问题。资料综合:通过文献回顾,发现决定同种异体气管移植成败的关键集中于以下3方面:①移植气管的血运建立。②移植气管的免疫原性及免疫反应强度。③移植气管组织细胞的再生。结论:在同种异体气管移植中各种相关因素的重要性及相互间的影响还需要进行深入分析。期望将来通过对各种组织诱导因子及局部应用的免疫抑制缓释剂的研究,在同种异体气管移植的研究领域中取得新突破。

BACKGROUND： Tracheal allotransplantation is the focus of studies on tracheal graft. Novel views and progress appear continuously. OBJECTIVE： To review and discuss the current situation and progress in tracheal allotransplantation, and introduce the latest method and ideal on tracheal allotransplantation in recent years. RETRIEVAL STRATEGY： A computer-based online search of ScienceDirect, Pubmed and Springer was undertaken for the English articles related to tracheal allotransplantation published from January 1990 to July 2007 with the keywords of ＂tracheal, allotransplantation, allograft＂. Meanwhile, we search CNKI for the related Chinese articles dated from January 1994 to July 2007 with the same keywords in Chinese. 328 articles were selected firstly, and 140 were in accordance with the criteria. Finally 30 articles about tracheal allotransplantation were selected for this summary. The repetitive researches were excluded. LITERATURE EVALUATION： Of the 30 articles, 7 were experiments analyzing the vascularization in transplanted trachea, 17 discussing the rejection, and 6 exploring the tissue and cell regeneration of transplanted trachea and tissue inducting factor. DATA SYNTHESIS： The articles suggest that there are three factors determining the success of tracheal allotransplantation： ①vascularization of transplanted trachea; ②immunogenicity and response intensity of transplanted trachea; ③regeneration of tissue and cells after tracheal allotransplantation. CONCLUSION： The importance of correlated factors and their interaction in tracheal allotransplantation need further investigation. There would be new progression in tracheal allotransplantation through the study at inducing factor and the retarder of immunodepressant locally administered.