Basic Research of Heart Lung Transplantation

本研究采用日本猕猴单肺移植模型，研究同种和异种肺移植的免疫反应。(1)未使用免疫抑制剂的同种异体肺移植猴在7天内胸部X线片显示实变，显微镜检查显示移植物排斥。接受FK 506免疫抑制的猴存活5 - 182天，认为7只同种异体移植物中有6只在动物死亡或处死时仍有功能。FK 506是一种有效的同种异体肺移植免疫抑制剂。(2)目的：探讨胸腔灌洗液（PLF）诊断同种和异种肺移植排斥反应的可行性。PLF中淋巴细胞亚群的变化与外周血无关，随着移植肺排斥反应的发生，PLF中淋巴细胞CD 4 +/CD 8+比值下降。(3)免疫荧光染色法观察移植肺组织。即使在临床充分的免疫抑制下，也能识别MHC 1类和2类抗原的表达。移植物中的CD 4（+）、CD 8（+）和CD 20（+）细胞在移植排斥反应中起重要作用。

Immunological response to allo- and xeno-lung graft was studied in this project using single lung transplantation model with Japanese Macaque monkeys. (1) Monkeys with lung allograft without immunosuppression showed consolidation by chest roentgenogram within 7 days and microscopic examination revealed rejected allograft. Monkeys with FK506 immunosuppression survived from 5 to 182 days and 6 allograft out of seven were considered to be functioning at the time of animal death or sacrifice. FK506 was considered as effective immunosuppressant for allotransplantation of the lung. (2) The feasibility of pleural lavage fluid(PLF) for the diagnosis of pulmonary allo- and xenograft rejection was studied. The change of lymphocyte subsets in PLF was independent from that in peripheral blood, and that CD4+/CD8+ ratio of lymphocytes in PLF decreased as the grafted lung was rejected. (3) Allografted lungs were examined with immunofluorescent staining methods. The expression of the MHC class 1 and 2 antigens were recognized even under clinically sufficient immunosuppression. CD4(+) cells, CD8(+) cells, and CD20(+) cells in the allograft was considered to play important role in the allograft rejection.