不同冷冻技术对同种异体血管移植排斥反应的影响

Effects of different freezing techniques on the rejection of allogeneic vascular transplantation

背景:冻存能够较好地保证血管结构的完整性,如何改善移植后排斥反应的问题受到越来越多的关注。目的:综述不同冷冻技术降低同种异体血管移植排斥反应的研究进展,以期为临床研究提供参考。方法:系统检索中英文数据库CNKI、万方和PubMed以及在线网站Baidu和Google Scholar自建库以来发表的降低同种异体血管移植排斥反应的相关文献。中文检索关键词:心血管疾病、内皮细胞、低温冻存、血管移植、免疫原性、排斥反应,同种异体移植和冷冻保护剂;英文检索关键词:cardiovascular disease、endothelial cells、cryopreservation、blood vessel transplantation or vascular graft、Immunogenicity、immune rejection、allograft or allogeneic transplantation or allograft transplantation and cryoprotectant。按照纳入排除标准共选取68篇文献进行综述。结果与结论:①综述发现通过改进现有冷冻技术能够降低同种异体血管移植排斥反应,其中主要涉及冻融方式和冻存保护剂的选择。②现有研究提示冻干法优于低温冻存,但限于条件未能广泛开展,现仍以低温冻存为主,其中玻璃化冻存、缓慢复温和使用不锈钢乃至含银材料效果优于程序式冻存及快速复温。③渗透性和非渗透性冻存保护剂的联合选择,可以在降低其毒性的同时,进一步减少排斥反应的发生。

BACKGROUND:Cryopreservation can better ensure the integrity of the vascular structure.How to reduce its immunogenicity to improve rejection after transplantation has attracted more and more attention.OBJECTIVE:To review the research progress of freezing treatment to reduce vascular immunogenicity after allogeneic vascular transplantation in order to provide a reference for clinical research.METHODS:A systematic search of Chinese and English databases CNKI,WanFang and PubMed,as well as online websites Baidu and Google Scholar since the establishment of the database has published literature on reducing vascular immunogenicity after allogeneic vascular transplantation.Keywords were“cardiovascular disease,endothelial cells,cryopreservation,blood vessel transplantation or vascular graft,immunogenicity,immune rejection,allograft or allogeneic transplantation or allograft transplantation and cryoprotectant”.A total of 68 articles were included according to the inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1)The review found that the rejection of allogeneic vascular transplantation can be reduced by improving the existing freezing technology,which mainly involves the selection of freezing and thawing methods and cryoprotectants.(2)The existing research suggests that the freeze-drying method is superior to the low-temperature cryopreservation,but due to the limited conditions,it is still dominated by low-temperature cryopreservation.Among them,vitrification cryopreservation,slow rewarming and the use of stainless steel and even silver-containing materials are better than programmed cryopreservation and rapid rewarming.(3)The combined selection of permeable and non-permeable cryoprotectants can further reduce the occurrence of rejection while reducing their toxicity.