血清sPTA1与人活体小肠移植急性排斥反应的相关性评价

Evaluation on the interrelationship between serum sPTA1 level and allograft acute rejection in living-related small bowel transplantation

目的观察我国首例父子间活体小肠部分移植术患者围手术期血清可溶性血小板/T细胞活化抗原1(sPTA1)水平与排斥反应的相关性。方法用夹心ELISA法测定血清sPTA1水平。结果 于术后第67d出现移植物排斥反应。从发生排斥反应前2周开始,sPTA1呈逐渐升高 趋势,于排斥反应前5 d已达60.49 ng/ml,前1 d达71.64 ng/ml。经加强免 疫抑制后,血清sPTA1水平于次日迅速下降。结论活 体部分小肠 移植患者移植物浸润的杀伤性T细胞的活化是一个渐进的过程,只有在活化到一定程度时( 本例达术前近2倍时),才出现肉眼和组织病理学可见的移植物急性排斥反应,且血清sPTA1的下降较组织学恢复迅速。

Objective To study the interrelationship between the changes in se rum sPTA1 level and the acute small bowel allograft rejection in the first case of living related small bowel transplantation in China.Methods It was the first time that solid-phase double ligand ELISA method was used to analyzed serum level of sPTA1. Results Allograft acute rejection occurred on the 67th day . sPTA1 serum level increased two weeks before the rejection and reached to 60.49 ng/mL at the 5th day,peaked at one day before rejection to 71 . 64 ng/mL,then decreased quickly to the preoperation level on the second day of rejection with more immunosuppressive agent.Conclusions The activation of infiltration T cell in the allograft of livin g-related small bowel transplantation was a gradual process. The allograft did not show signs of acute rejection to the naked eye and/or histopathological ch anges under the microscope until the activation reached to a certain level (two times more than that of preoperation). Moreover,the changes of the serum sPTA1 level occurred earlier than that in histopathology.