兔同种异体颜面移植皮肤及附属器变化的实验研究

Study on Changes of Hemifacial Composite Tissue and its Appendages after Allotransplantation in Rabbits

目的研究兔半侧颜面部复合组织同种异体移植皮肤及附属器的变化。方法以日本大耳白兔和青紫蓝兔为实验动物,共16只;取体质量相近的2只分别为供受体。以颈总动脉和颈外静脉为供血及回流血管,进行兔半侧颜面复合组织同种异体移植;他克莫司和强的松联合应用作为免疫抑制治疗方案,定期抽取外周静脉血进行血药浓度检测,以调整普乐可复的用量。术后7,30,40 d切取移植组织进行组织学检查。结果 8例行面部异体移植的受体兔中,1只术后第3天因移植物内出血形成口底血肿而使兔窒息死亡;1只因静脉回流不畅,术后第3天出现皮瓣坏死,其余6例平均存活24 d（6~40 d）。本组无因麻醉死亡。组织学观察术后1周,皮肤附属器较正常增多,汗腺增生最明显,结构尚正常,无明显淋巴细胞浸润;术后30,40 d皮肤附属器未见明显增生,结构正常,无淋巴细胞浸润。结论兔同种异体半侧颜面移植后皮肤附属器较正常增多,未见退行性变化。

Objective To study the changes of hemifacial composite tissue and its appendages after allotransplantation in rabbits.Methods Sixteen Japanese white rabbits and livid blue rabbits of similar weight were chosen as donor and recipient.Carotid artery and external jugular vein were used as blood supply and vascular reflux for allograft of rabbit hemifacial composite tissue;FK506 and prednisone were used as the immunosuppressive agent;peripheral venous blood was taken for blood concentration testing in order to adjust the dosage of tacrolimus.After 7 days,30 days,and 40 days,transplanted tissue was cut for histological examination.Results Among the 8 cases of facial allograft,there was one case of death due to the formation of graft hematoma and one case of skin flap necrosis because of poor venous reflux.The remaining six cases had an average survival period of 24 days,the shortest cases being 6 days and the longest over 40 days.There was no case of death due to anesthesia.Histology observations showed that during the first postoperative week,the number of skin appendages was higher than that of the normal,the most obvious hyperplasia being the sweat glands.The structure of the skin appendages was still normal and no apparent lymphocyte infiltration was found.After 30 days and 40 days,there was no obvious skin appendage hyperplasia.The structure of the skin appendages was similar to the normal and there was no lymphocytic infiltration.Conclusion After hemifacial allotransplantation in rabbits,the number of skin appendages is higher than that of the normaland there is no degenerative changes.