同种异体复合组织移植Banff移植病理学诊断标准及进展

Diagnostic criteria and research progress on Banff classification of allograft pathology in composite tissue allotransplantation

同种异体复合组织移植(CTA)是一门新兴的用于治疗功能性组织或肢体缺损的移植学科,由于绝大多数CTA移植物为带血管的移植物,因此也称为带血管的复合组织移植(VCA)。CTA/VCA的移植物包含同种异体的皮肤、皮下组织、骨骼、肌肉、神经和血管等两种或多种组织结构成分。由于大多数CTA/VCA移植物中带有皮肤组织,而皮肤组织是抗原性最强的免疫成分,移植术后的急性排斥反应是导致CTA/VCA移植失败及其移植物失功的首要障碍,因此CTA/VCA移植物中的皮肤排斥反应的组织病理学特征成为首要的关注点。本文就CTA/VCA的排斥反应等病理学特征、2007年Banff诊断标准及其研究进展予以综述,以期为CTA/VCA的排斥反应及其他并发症的诊断及治疗提供参考。

Composite tissue allotransplantation(CTA)is a novel transplantation discipline to treat functional tissue or limb defects.Since a majority of CTA grafts were vascularized grafts,it is also known as vascularized composite allotransplantation(VCA).The grafts of CTA/VCA consist of two or more types of allogeneic skin,subcutaneous tissue,bone,muscle,nerve and vessel,etc.Most of CTA/VCA grafts contain skin tissues,which possess the highest antigenicity.Acute rejection after transplantation is the primary obstacle leading to CTA/VCA graft failure and primary graft dysfunction.Hence,histopathological characteristics of skin rejection in CTA/VCA grafts have become the primary hotspot.In this article,pathological features of CTA/VCA rejection,Banff classification in 2007 and related research progress were reviewed,aiming to provide reference for the diagnosis and treatment of rejection and other complications of CTA/VCA.